Tenino Denture Center, LLC

NPI #1366885204 in Tenino, Washington

Provider Information

NPI Number: 1366885204
Entity Type: Organization
Organization Name: Tenino Denture Center, LLC
Primary Specialty: Denturist
Enumeration Date: Apr 10, 2013
Last Updated: Apr 10, 2013

Practice Location

Address: 296 SUSSEX AVE W
City: Tenino
State: Washington
ZIP Code: 98589-9360
Phone: (360) 264-5500

Authorized Official

Name: MAENELL SULLIVAN
Title: MEMBER
Phone: (360) 264-5500

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Denturist	122400000X	Primary

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