Organization
MOUNTAIN VIEW DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN CRUSAN DDS (OWNER/DENTIST)
(360) 887-1177
Entity
Organization
Contact information
Practice address
2 S 56TH PL, SUITE 202, RIDGEFIELD, WA 98642-3425
(360) 887-1177
(360) 887-1178
Mailing address
2 S 56TH PL, SUITE 202, RIDGEFIELD, WA 98642-3425
(360) 887-1177
(360) 887-1178
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE7985
WA
Other
Enumeration date
11/28/2016
Last updated
11/28/2016
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