Advanced Denture & Implant, Inc
Organization Active NPI Denturist · Vancouver, WA
NPI 1801837463 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1801837463
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Denturist 122400000X
- License
- DN0130 (WA)
- Legal business name
- ADVANCED DENTURE & IMPLANT, INC
- Practice address
- 14602 NE 4TH Plain Rd
Suite G
Vancouver, WA 98682 - Phone
- (360) 882-4884
- Fax
- (360) 882-7588
- NPI assigned
- Jun 8, 2006
- Organization subpart
- No
Authorized official
- Name
- Diane Yvonne Goldsby
- Title
- President
- Phone
- (360) 260-0122
Practitioners 1
National Provider Directory
Locations
14602 NE Fourth Plain Blvd
Ste G
Vancouver, WA 98682
Phone (360) 882-4884
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Denturist |
122400000X | DN0130 | WA | Yes |
Addresses
Primary practice location
14602 NE 4TH Plain Rd
Suite G
Vancouver, WA 98682
Mailing address
3705 NE 154TH Ave
Vancouver, WA 98682-7418
Phone (360) 882-4884
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5045372 | Medicaid | WA |
Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.