Organization Name: | MOUNTAIN VIEW DENTAL CENTER, PS |
NPI Number: | 1093950222 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOHN ANDREW SAVAGE (DENTIST/OWNER) |
Mailing Address: | 708 E Mountain View Ave Ellensburg |
State: | WA US |
Postal Code: | 989263862 |
Phone Number: | 5099622755 |
Fax Number: | 5099622750 |
NPI Enumeration Date: | 12/02/2008 |
NPI Last Update Date: | 12/02/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QD0000X |
License Number: | DE00007009 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Dental |
Taxonomy Definition: |