Organization
DENTAL PROFESSIONALS OF WASHINGTON QUIRT MONGRAIN GIBREE PC
Active
Parent organization
DENTAL PROFESSIONALS OF WASHINGTON QUIRT MONGRAIN GIBREE PC
Other names
Chapel Hill Family Dentistry
Organization subpart
Yes
Provider details
NPI number
Legal business name
DENTAL PROFESSIONALS OF WASHINGTON QUIRT MONGRAIN GIBREE PC
Authorized official
TABATHA LEMKE (CREDENTIALING COORDINATOR)
(217) 540-6078
Entity
Organization
Contact information
Practice address
9514 4TH ST NE UNIT 102, LAKE STEVENS, WA 98258-1937
(425) 334-4001
Mailing address
9514 4TH ST NE UNIT 102, LAKE STEVENS, WA 98258-1937
(425) 334-4001
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
07/16/2020
Last updated
07/16/2020
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