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Individual

WILLIAM S. DISANTIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.

Contact information

Practice address
210 S 11TH AVE, SUITE #45, YAKIMA, WA 98902-3293
(509) 454-2273
(509) 454-7901
Mailing address
210 S 11TH AVE, SUITE #45, YAKIMA, WA 98902-3293
(509) 454-2273
(509) 454-7901

Taxonomy

Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
DN00000367
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5048293
WA
01
DN00000367
LICENSE NUMBER
WA
Enumeration date
12/28/2006
Last updated
07/09/2007
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