Jay W Magnuson, D.D.S

Individual provider Active NPI General Practice Dentistry · Quincy, WA

NPI 1740205178 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1740205178
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
3968 (WA)
Practice address
201 H St SE
Quincy, WA 98848-1507
Phone
(509) 787-1507
Fax
(509) 787-2100
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
3968WAMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3968 WA Yes

Addresses

Primary practice location

201 H St SE
Quincy, WA 98848-1507

Mailing address

201 H St SE
Quincy, WA 98848-1507
Phone (509) 787-1507

Other providers in Quincy, WA

All providers in Quincy, WA · General Practice Dentistry in Washington

Sources for this page

Verify at the official NPI Registry.