Organization
TRI-STAR DENTURE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LENARD GOBIN DEOCHAND LD, DD (DENTURIST)
(360) 906-0015
Entity
Organization
Contact information
Practice address
2802 COLUMBIA ST, VANCOUVER, WA 98660-2220
(360) 906-0015
(360) 906-0023
Mailing address
2802 COLUMBIA ST, VANCOUVER, WA 98660-2220
(360) 906-0015
(360) 906-0023
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
WA00008442
WA
122400000X
Denturist
Primary
DN00000394
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
278500
—
OR
05
—
5047667
—
WA
Enumeration date
06/07/2010
Last updated
06/07/2010
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