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Organization

H KIRBY SKAVDAHL DDS PS

Active
Other names
Tri-Cities Periodontics & Implants
Organization subpart
No

Provider details

NPI number
Authorized official
DR. HOWARD KIRBY SKAVDAHL DDS (OWNER)
(509) 783-5722
Entity
Organization

Contact information

Practice address
7409 W GRANDRIDGE BLVD, SUITE B, KENNEWICK, WA 99336-6710
(509) 783-5722
(509) 735-2822
Mailing address
7409 W GRANDRIDGE BLVD, SUITE B, KENNEWICK, WA 99336-6710
(509) 783-5722
(509) 735-2822

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
5324
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1245368604
INDIVIDUAL NPI #
Enumeration date
07/13/2016
Last updated
07/13/2016
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