Provider Demographics
NPI:1629086517
Name:ALDER, BRIAN CALL (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:CALL
Last Name:ALDER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14609 NW 52ND CT
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98685-0512
Mailing Address - Country:US
Mailing Address - Phone:360-253-7208
Mailing Address - Fax:
Practice Address - Street 1:8700 NE HAZEL DELL AVE
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98665-8067
Practice Address - Country:US
Practice Address - Phone:360-574-8700
Practice Address - Fax:360-573-8008
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA87441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice