Organization
THREE RIVERS DENTAL LLC
Active
Other names
Three Rivers Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JARED DOMAN (OWNER)
(360) 601-9454
Entity
Organization
Contact information
Practice address
620 TRIANGLE SHOPPING CTR STE 660, LONGVIEW, WA 98632-4690
(360) 803-8003
Mailing address
633 NW 164TH ST, RIDGEFIELD, WA 98642-9478
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
02/07/2023
Last updated
02/07/2023
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