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Organization

EAST FORK DENTAL LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KARL ROSE DDS (OWNER)
(360) 687-6556
Entity
Organization

Contact information

Practice address
15 SW 20TH AVE, BATTLE GROUND, WA 98604-3133
(360) 687-5665
Mailing address
PO BOX 157, BATTLE GROUND, WA 98604-0157

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Enumeration date
12/16/2018
Last updated
12/16/2018
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