Organization
CASCADE FAMILY DENTAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SRIDEVI VIJAYASEKARAN DMD (PRESIDENT)
(360) 456-1234
Entity
Organization
Contact information
Practice address
8765 TALLON LN NE, SUITE I, LACEY, WA 98516-6654
(360) 456-1234
Mailing address
8765 TALLON LN NE, SUITE I, LACEY, WA 98516-6654
(360) 456-1234
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE00009476
WA
Other
Enumeration date
05/10/2010
Last updated
05/10/2010
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