Eleven Eleven Dental

NPI 1073763041 - Clinic/Center - 261QD0000X

NPI Details
NPI 1073763041
Enumeration Date 09/25/2008
Last Updated 09/25/2008
Entity Type Healthcare Provider
Active Over 8 years ago
Authorized Information
Name GREGORY L GREGORY
Position PRESIDENT/OWNER
Phone (360) 457-3183
Fax
Practice Location
1111 COLUMBIA ST
PORT ANGELES WA, 98362-4207, US
Phone (360) 457-3183
Fax
Business Location
1111 COLUMBIA ST
PORT ANGELES WA, 98362-4207, US
Phone (360) 457-3183
Fax
Toxanomy
Taxonomy Code 261QD0000X
License State Washington
License Number 602789281
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According to our database, Eleven Eleven Dental NPI is 1073763041, taxonomy code is 261QD0000X and license number is 602789281, license state is located at Washington. Eleven Eleven Dental physically located at 1111 Columbia St, Port Angeles WA, 98362-4207. NPI Number 1033115704 has the healthcare provider type.

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1073763041 NPI number is provided on an as is basis without warranty of any kind. 1073763041 is maintained by the National Plan & Provider Enumeration System. The contents of Eleven Eleven Dental are for informational purposes only.