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NATE REPTA DMD PS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NATE REPTA DMD (SHAREHOLDER)
(503) 453-3641
Entity
Organization

Contact information

Practice address
275 PENDLETON WAY, WASHOUGAL, WA 98671-4203
(503) 453-3641
Mailing address
693 32ND ST UNIT 5, WASHOUGAL, WA 98671-1865

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary

Other

Enumeration date
08/16/2019
Last updated
08/16/2019
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