Dental Professionals of Washington Quirt Mongrain Gibree PC
NPI #1104566728 in Lacey, Washington
Provider Information
- NPI Number
- 1104566728
- Entity Type
- Organization
- Organization Name
- Dental Professionals of Washington Quirt Mongrain Gibree PC
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- DENTAL PROFESSIONALS OF WASHINGTON QUIRT MONGRAIN GIBREE PC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Mar 31, 2022
- Last Updated
- Apr 13, 2022
Practice Location
- Address
- 4445 LACEY BLVD SE
- City
- Lacey
- State
- Washington
- ZIP Code
- 98503-5716
- Phone
- (360) 491-2532
Authorized Official
- Name
- HILLARY THULL
- Title
- CREDENTIALING COORDINATOR
- Phone
- (217) 540-8946
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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