Provider Demographics
NPI:1205147840
Name:NEW DAY COMMUNITY DENTAL CLINIC
Entity type:Organization
Organization Name:NEW DAY COMMUNITY DENTAL CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHELLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:GUINN
Authorized Official - Suffix:
Authorized Official - Credentials:RDH
Authorized Official - Phone:360-909-0298
Mailing Address - Street 1:1201 SE TECH CENTER DR STE 150
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683-5523
Mailing Address - Country:US
Mailing Address - Phone:360-892-7107
Mailing Address - Fax:360-759-6552
Practice Address - Street 1:1201 SE TECH CENTER DR STE 150
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683-5523
Practice Address - Country:US
Practice Address - Phone:360-892-7107
Practice Address - Fax:360-759-6552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-29
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental