Provider Demographics
NPI:1295233344
Name:R.C. DOWNING DDS PS
Entity type:Organization
Organization Name:R.C. DOWNING DDS PS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:C
Authorized Official - Last Name:DOWNING
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:360-259-1984
Mailing Address - Street 1:PO BOX 173
Mailing Address - Street 2:
Mailing Address - City:HOODSPORT
Mailing Address - State:WA
Mailing Address - Zip Code:98548-0173
Mailing Address - Country:US
Mailing Address - Phone:360-877-5151
Mailing Address - Fax:
Practice Address - Street 1:68 N LAKE CUSHMAN ROAD
Practice Address - Street 2:
Practice Address - City:HOODSPORT
Practice Address - State:WA
Practice Address - Zip Code:98548-9854
Practice Address - Country:US
Practice Address - Phone:360-878-5151
Practice Address - Fax:206-400-5997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-24
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000090671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WADE00009067OtherDENTAL LICENSE NUMBER