Organization
CHARTER COLLEGE LLC
Active
Other names
Charter College Dental Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL DAWSON (PRESIDENT/CEO)
(775) 737-7403
Entity
Organization
Contact information
Practice address
410 W BAKERVIEW RD STE 112, BELLINGHAM, WA 98226-8184
(360) 647-5000
(360) 647-5002
Mailing address
750 SANDHILL RD STE 100, RENO, NV 89521-4943
(775) 849-9900
(775) 284-9905
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DE00009350
WA
Other
Enumeration date
02/07/2012
Last updated
02/07/2012
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