Individual
VICTOR S STIME
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
34705 N NEWPORT HWY, RIVERSIDE DENTAL CLINIC, CHATTAROY, WA 99003-7711
(509) 292-2211
(505) 292-2209
Mailing address
21702 N PERRY RD, COLBERT, WA 99005-9487
(509) 468-2651
(509) 466-6615
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6177
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5004155
—
WA
Enumeration date
12/08/2005
Last updated
07/08/2007
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