Organization
DENTAL PROFESSIONALS OF WASHINGTON QUIRT MONGRAIN GIBREE PC
Active
Parent organization
HEARTLAND DENTAL
Other names
Walla Walla Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
HEARTLAND DENTAL
Authorized official
TABATHA LEMKE (CREDENTIALING COORDINATOR)
(217) 540-6078
Entity
Organization
Contact information
Practice address
2014 HOWARD ST STE A, WALLA WALLA, WA 99362-4532
(509) 525-4833
Mailing address
2014 HOWARD ST STE A, WALLA WALLA, WA 99362-4532
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/03/2021
Last updated
09/03/2021
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