Provider Demographics
NPI:1972717825
Name:BELLINGHAM TECHNICAL COLLEGE
Entity Type:Organization
Organization Name:BELLINGHAM TECHNICAL COLLEGE
Other - Org Name:DENTAL CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:KRISTI
Authorized Official - Middle Name:
Authorized Official - Last Name:DUPPENTHALER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-752-8453
Mailing Address - Street 1:3028 LINDBERGH AVE
Mailing Address - Street 2:DENTAL CLINIC
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-1518
Mailing Address - Country:US
Mailing Address - Phone:360-752-8349
Mailing Address - Fax:
Practice Address - Street 1:3028 LINDBERGH AVE
Practice Address - Street 2:DENTAL CLINIC
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1518
Practice Address - Country:US
Practice Address - Phone:360-752-8349
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare