Individual
MR. CODY M DUNIVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LD
Contact information
Practice address
1339 COMMERCE AVE STE 309A, LONGVIEW, WA 98632-3738
(360) 232-8756
Mailing address
1339 COMMERCE AVE STE 309A, LONGVIEW, WA 98632-3738
(360) 232-8756
Taxonomy
Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
DN60869545
WA
Other
Enumeration date
01/08/2019
Last updated
06/02/2021
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