Individual
DR. GREGORY DALE CEBULLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2373 OLD TOKELAND RD, TOKELAND, WA 98590
(360) 267-8103
(360) 267-1437
Mailing address
PO BOX 500, TOKELAND, WA 98590-0500
(360) 267-8103
(360) 267-1437
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE00010391
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5051263
—
WA
Enumeration date
05/04/2007
Last updated
07/09/2007
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