Provider Demographics
NPI:1386192862
Name:ROBERT N. NAU, DDS, LLC
Entity Type:Organization
Organization Name:ROBERT N. NAU, DDS, LLC
Other - Org Name:OKANOGAN VALLEY DENTAL
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSALIND
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:NAU
Authorized Official - Suffix:
Authorized Official - Credentials:MME, NCTM
Authorized Official - Phone:509-422-4881
Mailing Address - Street 1:PO BOX 1457
Mailing Address - Street 2:232 SECOND AVE N
Mailing Address - City:OKANOGAN
Mailing Address - State:WA
Mailing Address - Zip Code:98840-1457
Mailing Address - Country:US
Mailing Address - Phone:509-422-4881
Mailing Address - Fax:509-422-4053
Practice Address - Street 1:232 SECOND AVE N
Practice Address - Street 2:
Practice Address - City:OKANOGAN
Practice Address - State:WA
Practice Address - Zip Code:98840-1457
Practice Address - Country:US
Practice Address - Phone:509-422-4881
Practice Address - Fax:509-422-4053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-14
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAD 000057411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty