Organization
ADVANCED DENTURE & IMPLANT, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE YVONNE GOLDSBY (PRESIDENT)
(360) 260-0122
Entity
Organization
Contact information
Practice address
14602 NE 4TH PLAIN RD, SUITE G, VANCOUVER, WA 98682
(360) 882-4884
(360) 882-7588
Mailing address
3705 NE 154TH AVE, VANCOUVER, WA 98682-7418
(360) 882-4884
(360) 882-7588
Taxonomy
Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
DN0130
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5045372
—
WA
Enumeration date
06/08/2006
Last updated
08/22/2020
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