Provider Demographics
NPI:1720087851
Name:BIRCHWOOD FINE DENTISTRY, INC.
Entity Type:Organization
Organization Name:BIRCHWOOD FINE DENTISTRY, INC.
Other - Org Name:DENNIS A. GALE, DDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:GALE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:360-671-6303
Mailing Address - Street 1:520 BIRCHWOOD AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-1700
Mailing Address - Country:US
Mailing Address - Phone:360-671-6303
Mailing Address - Fax:360-671-0091
Practice Address - Street 1:520 BIRCHWOOD AVE
Practice Address - Street 2:SUITE B
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1700
Practice Address - Country:US
Practice Address - Phone:360-671-6303
Practice Address - Fax:360-671-0091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000044931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5015631Medicaid