Organization
DENTAL PROFESSIONALS OF WASHINGTON, QUIRT, MONGRAIN, GIBREE, PC
Active
Parent organization
DENTAL PROFESSIONALS OF WASHINGTON, QUIRT, MONGRAIN, GIBREE, PC
Other names
Clover Creek Dental Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
DENTAL PROFESSIONALS OF WASHINGTON, QUIRT, MONGRAIN, GIBREE, PC
Authorized official
BELINDA HUERTA (CREDENTIALING COORDINATOR)
(217) 540-2100
Entity
Organization
Contact information
Practice address
17513 CANYON PKWY E STE 103, TACOMA, WA 98446-7500
(253) 330-8960
(253) 330-8938
Mailing address
17513 CANYON PKWY E STE 103, TACOMA, WA 98446-7500
(253) 330-8960
(253) 330-8938
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/06/2023
Last updated
09/06/2023
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