Individual
DONNA IVETTE PONCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
605 S COOLIDGE ST, MOSES LAKE, WA 98837-1893
(509) 765-0674
(509) 766-1035
Mailing address
605 S COOLIDGE ST, MOSES LAKE, WA 98837-1893
(509) 765-0674
(509) 766-1035
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH60980290
WA
Other
Enumeration date
07/03/2019
Last updated
05/28/2021
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