Organization
KIRKS DENTUER CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMBER RAI DELANEY (OFFICE MANAGER)
(360) 740-9883
Entity
Organization
Contact information
Practice address
2048 NE KRESKY AVE, CHEHALIS, WA 98532-2322
(360) 740-9883
(360) 740-1894
Mailing address
2048 NE KRESKY AVE, CHEHALIS, WA 98532-2322
(360) 740-9883
(360) 740-1894
Taxonomy
Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
DN00000170
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5050216
—
WA
01
—
9118342
TAX ID #
WA
Enumeration date
05/23/2007
Last updated
08/22/2020
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