Provider Demographics
NPI:1184986531
Name:DALE E IRELAND
Entity type:Organization
Organization Name:DALE E IRELAND
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:WIFE/DENTIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:R
Authorized Official - Last Name:IRELAND
Authorized Official - Suffix:I
Authorized Official - Credentials:
Authorized Official - Phone:360-692-9701
Mailing Address - Street 1:9951 MICKELBERRY RD. N.W.
Mailing Address - Street 2:SUITE 215
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383
Mailing Address - Country:US
Mailing Address - Phone:360-692-9701
Mailing Address - Fax:
Practice Address - Street 1:9951 MICKELBERRY RD NW
Practice Address - Street 2:SUITE 215
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-8309
Practice Address - Country:US
Practice Address - Phone:360-692-9701
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-12
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty