Organization
QUIRT MONGRAIN GIBREE - MARYVILLE, PC
Active
Parent organization
QUIRT MONGRAIN GIBREE - MARYVILLE, PC
Other names
Artesian Dental on Lacey Boulevard
Organization subpart
Yes
Provider details
NPI number
Legal business name
QUIRT MONGRAIN GIBREE - MARYVILLE, PC
Authorized official
COURTNEY R MONTEITH (CREDENTIALING COORDINATOR)
(217) 540-8306
Entity
Organization
Contact information
Practice address
4445 LACEY BLVD SE, LACEY, WA 98503-5716
(360) 491-2532
Mailing address
4445 LACEY BLVD SE, LACEY, WA 98503-5716
(360) 491-2532
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/10/2022
Last updated
05/10/2022
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