Organization
ALPHA DENTURE CLINIC, INC
Active
Parent organization
ALPHA DENTURE CLINIC, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ALPHA DENTURE CLINIC, INC
Authorized official
MRS. DOROTHY JENSEN (BUSINESS MGR)
(360) 658-0256
Entity
Organization
Contact information
Practice address
1242 STATE AVE, SUITE G, MARYSVILLE, WA 98270-3672
(360) 658-0256
(360) 658-7280
Mailing address
1242 STATE AVE, SUITE G, MARYSVILLE, WA 98270-3672
(360) 658-0256
(360) 658-7280
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
DN000021
WA
Other
Enumeration date
02/08/2012
Last updated
02/08/2012
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