Provider Demographics
NPI:1932334539
Name:URGENT DENTAL CARE LLC
Entity Type:Organization
Organization Name:URGENT DENTAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VAHID
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:ESHRAGHI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:360-574-0900
Mailing Address - Street 1:1307 NE 78TH ST
Mailing Address - Street 2:SUITE B13
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98665-9670
Mailing Address - Country:US
Mailing Address - Phone:360-574-0900
Mailing Address - Fax:360-573-6338
Practice Address - Street 1:1307 NE 78TH ST
Practice Address - Street 2:SUITE B13
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98665-9670
Practice Address - Country:US
Practice Address - Phone:360-574-0900
Practice Address - Fax:360-573-6338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-27
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00011249122300000X
WADE60061018122300000X
WADE00011144122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty