Organization
MOUNTAIN LAKE DENTURE SERVICES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHUA D BROOKS DPD (MEMBER)
(509) 303-9090
Entity
Organization
Contact information
Practice address
1225 MEADE AVE, PROSSER, WA 99350-1423
(509) 786-2963
(888) 656-9322
Mailing address
1225 MEADE AVE, PROSSER, WA 99350-1423
(509) 786-2963
(888) 656-9322
Taxonomy
Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
—
—
Other
Enumeration date
07/21/2010
Last updated
07/21/2010
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