Provider Demographics
NPI:1275052359
Name:CD CAMAS SE (DBA COMFORT DENTAL CAMAS)
Entity Type:Organization
Organization Name:CD CAMAS SE (DBA COMFORT DENTAL CAMAS)
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:306-768-5609
Mailing Address - Street 1:2004 SE 192ND AVENUE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683
Mailing Address - Country:US
Mailing Address - Phone:360-768-5609
Mailing Address - Fax:
Practice Address - Street 1:2004 SE 192ND AVE STE 101
Practice Address - Street 2:
Practice Address - City:CAMAS
Practice Address - State:WA
Practice Address - Zip Code:98607-6805
Practice Address - Country:US
Practice Address - Phone:360-768-5609
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental