Organization
THE PROFESSIONAL DENTURE CENTER
Active
Other names
Professional Denture Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN MUNGER DICKSON DMD (DOCTOR/OWNER)
(253) 230-8084
Entity
Organization
Contact information
Practice address
835 E COLONIAL AVE STE 103, MOSES LAKE, WA 98837-4617
(509) 707-0707
Mailing address
835 E COLONIAL AVE STE 103, MOSES LAKE, WA 98837-4617
(509) 707-0707
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
60292621
WA
122400000X
Denturist
60772847
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2059589
—
WA
Enumeration date
11/21/2017
Last updated
03/17/2025
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