Provider Demographics
NPI:1467895870
Name:HALF DENTAL WA INC.
Entity Type:Organization
Organization Name:HALF DENTAL WA INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:MPH
Authorized Official - Phone:702-876-2525
Mailing Address - Street 1:910 NE MINNEHAHA ST STE 12
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98665-8749
Mailing Address - Country:US
Mailing Address - Phone:702-876-2525
Mailing Address - Fax:702-876-1686
Practice Address - Street 1:910 NE MINNEHAHA ST STE 12
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98665-8749
Practice Address - Country:US
Practice Address - Phone:702-876-2525
Practice Address - Fax:702-876-1686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-16
Last Update Date:2013-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental