Provider Demographics
NPI:1942717079
Name:WASHINGTON DENTAL CORPORATION, PC
Entity Type:Organization
Organization Name:WASHINGTON DENTAL CORPORATION, PC
Other - Org Name:MARYSVILLE MODERN DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:MCGLASHAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:360-718-3098
Mailing Address - Street 1:17000 RED HILL AVE
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92614-5626
Mailing Address - Country:US
Mailing Address - Phone:714-845-8500
Mailing Address - Fax:303-952-0892
Practice Address - Street 1:8820 36TH AVE NE STE 103
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98270-7268
Practice Address - Country:US
Practice Address - Phone:360-718-3098
Practice Address - Fax:360-718-3138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-10
Last Update Date:2018-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty