South Beach Dental Clinic

NPI #1437690955 in Westport, Washington

Provider Information

NPI Number: 1437690955
Entity Type: Organization
Organization Name: South Beach Dental Clinic
Primary Specialty: Dentist - General Practice
Enumeration Date: Mar 16, 2017
Last Updated: Mar 16, 2017

Practice Location

Address: 509 S MONTESANO ST
City: Westport
State: Washington
ZIP Code: 98595
Phone: (360) 268-6225

Authorized Official

Name: DUANE W PEGG, DMD
Title: PRESIDENT
Phone: (360) 268-6225

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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