Organization
JEREMY H DIEHL, D.D.S., M.S.D., PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEREMY H DIEHL D.D.S., M.S.D. (PRESIDENT)
(360) 693-1200
Entity
Organization
Contact information
Practice address
2702 NE 78TH ST, SUITE 108, VANCOUVER, WA 98665-0665
(360) 693-1200
(360) 693-2001
Mailing address
2702 NE 78TH ST, SUITE 108, VANCOUVER, WA 98665-0665
(360) 693-1200
(360) 693-2001
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
DE60083669
WA
Other
Enumeration date
06/23/2009
Last updated
05/28/2014
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