Clarkston Denturist Clinic

NPI #1538487665 in Clarkston, Washington

Provider Information

NPI Number: 1538487665
Entity Type: Organization
Organization Name: Clarkston Denturist Clinic
Primary Specialty: Denturist
Enumeration Date: May 13, 2010
Last Updated: May 13, 2010

Practice Location

Address: 1346 12TH ST
City: Clarkston
State: Washington
ZIP Code: 99403-2821
Phone: (509) 758-7805

Authorized Official

Name: MR. ELDRED DONALD OLSON, L.D.
Title: OWNER/OPERATOR
Phone: (509) 758-7805

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Denturist	122400000X	Primary

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