Individual
JANA MOGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LD LICENSED DENTURIS
Contact information
Practice address
2314 FORT VANCOUVER WAY, VANCOUVER, WA 98663
(360) 694-2316
Mailing address
2314 FORT VANCOUVER WAY, VANCOUVER, WA 98663
(360) 694-2316
Taxonomy
Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
DN00000005
WA
122400000X
Denturist
DTDO302276
OR
Other
Enumeration date
01/17/2007
Last updated
07/08/2007
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