Calvin L. Despain, DDS, PLLC
Dentist, General Practice in Moses Lake, WA. Organization (NPI-2).
NPI number1962007682
StatusActive
Last updated in NPPESDec 1, 2020
Details
- NPI
- 1962007682
- Entity type
- Organization (NPI-2)
- Legal business name
- Calvin L. Despain, DDS, PLLC
- Organization subpart
- No
- Enumeration date
- Dec 1, 2020
- Certification date
- Dec 1, 2020
- Last updated
- Dec 1, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
Practice location
1336 E Hunter PlMoses Lake, WA 98837-2449
Phone 509-766-7076
Mailing address
4514 W Peninsula DrMoses Lake, WA 98837-3031
Authorized official
Calvin L Despain
Owner/Dentist
2085504430
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