Individual
AMANDA MICHELLE CORDERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
2690 NE KRESKY AVE, CHEHALIS, WA 98532-2412
(360) 330-9595
(360) 330-9580
Mailing address
2690 NE KRESKY AVE, CHEHALIS, WA 98532-2412
(360) 330-9595
(360) 330-9560
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE60604991
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2053768
—
WA
Enumeration date
07/08/2014
Last updated
10/20/2016
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