Organization
DENTAL PROFESSIONALS OF WASHINGTON QUIRT MONGRAIN GIBREE PC
Active
Parent organization
DENTAL PROFESSIONALS OF WASHINGTON, QUIRT, MONGRAIN, GIBREE, PC
Other names
Wilderness Dental Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
DENTAL PROFESSIONALS OF WASHINGTON, QUIRT, MONGRAIN, GIBREE, PC
Authorized official
JESSICA BRITT (CREDENTIALING COORDINATOR)
(217) 540-5100
Entity
Organization
Contact information
Practice address
23818 225TH AVE SE STE 100, MAPLE VALLEY, WA 98038-5088
(425) 358-2553
(425) 358-7092
Mailing address
23818 225TH AVE SE STE 100, MAPLE VALLEY, WA 98038-5088
(425) 358-2553
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/10/2020
Last updated
01/15/2021
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