Republic Dental Clinic

NPI 1164749396 - Dentist - 122300000X

NPI Details
NPI 1164749396
Enumeration Date 04/28/2010
Last Updated 04/28/2010
Entity Type Healthcare Provider
Active Over 6 years ago
Authorized Information
Name ROBERT W. ROBERT
Position OWNER/DENTIST
Phone (509) 775-3169
Fax (509) 775-2272
Practice Location
194 N. PORTLAND ST.
REPUBLIC WA, 99166-0978, US
Phone (509) 775-3169
Fax (509) 775-2272
Business Location
PO BOX 978
REPUBLIC WA, 99166-0978, US
Phone (509) 775-3169
Fax (509) 775-2272
Toxanomy
Taxonomy Code 122300000X
License State Washington
License Number 5070
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According to our database, Republic Dental Clinic NPI is 1164749396, taxonomy code is 122300000X and license number is 5070, license state is located at Washington. Republic Dental Clinic physically located at 194 N. Portland St., Republic WA, 99166-0978. NPI Number 1033115704 has the healthcare provider type.

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1164749396 NPI number is provided on an as is basis without warranty of any kind. 1164749396 is maintained by the National Plan & Provider Enumeration System. The contents of Republic Dental Clinic are for informational purposes only.