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Organization

PACIFIC NORTHWEST DENTAL GROUP, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CHAD KLEVEN DDS (OWNER)
(360) 995-0025
Entity
Organization

Contact information

Practice address
2728 WESTMOOR CT SW STE D, OLYMPIA, WA 98502-5779
(360) 995-0025
(360) 995-0027
Mailing address
870 11TH AVE, LONGVIEW, WA 98632-2402

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Enumeration date
03/18/2021
Last updated
03/18/2021
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