Individual
DR. RAYMOND CLYDE WINTERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
4408 PACIFIC AVE SE, LACEY, WA 98503-1119
(360) 438-8299
(360) 438-1399
Mailing address
1519 6TH AVE SW, OLYMPIA, WA 98502-5249
(360) 570-0327
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
00004147
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5358403
—
WA
01
—
823455
UNITED CONCORDIA
WA
Enumeration date
10/03/2006
Last updated
07/08/2007
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