Individual
DR. BRIAN E MAHONEY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3512 MAIN ST, VANCOUVER, WA 98663-2224
(360) 696-2513
(360) 696-0268
Mailing address
3512 MAIN ST, VANCOUVER, WA 98663-2224
(360) 696-2513
(360) 696-0268
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6106
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5002266
—
WA
Enumeration date
06/14/2005
Last updated
07/08/2007
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