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Organization

CUSTOM DENTAL INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ROBERT A FORD LDN (PRESIDENT)
(509) 457-8768
Entity
Organization

Contact information

Practice address
1103 S 20TH AVE, YAKIMA, WA 98902-5210
(509) 457-8768
Mailing address
1103 S 20TH AVE, YAKIMA, WA 98902-5210
(509) 457-8768

Taxonomy

Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
DN00000326
WA

Other

Enumeration date
09/12/2007
Last updated
09/12/2007
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