Tietan Dental Team

Dental Clinic

 
1602 Penny Ln, Walla Walla
    Washington, 99362-4477

 509-522-0940    509-525-9063 Maps & Directions
Tietan Dental Team is a Dental Clinic in Walla Walla, Washington. It is located at 1602 Penny Ln, Walla Walla, WA and its contact number is 509-522-0940. The authorized person for Tietan Dental Team is Dr. Don R Kellogg who is Secretary of the clinic and their contact number is 509-522-0940. The primary license number for Tietan Dental Team is DE00004225 (Dentist) in Washington.
Tietan Dental Team Clinic have dental surgeons who are specialized in dentistry, diagnosis, prevention, and treatment of diseases and conditions of the oral cavity. The dentist's supporting team aids in providing oral health services. The dental team includes dental assistants, dental hygienists, dental technicians, and sometimes dental therapists.
Complete Clinic Profile:
Tietan Dental Team Clinic speciality, address, contact phone number and fax are as below. Patients can call on the below given phone number for appointments.
Name: Tietan Dental Team
Specialization: Dentistry
Clinic Address:1602 Penny Ln, Walla Walla,
Washington, 99362-4477
Phone:509-522-0940
Fax:509-525-9063
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
Name: Dr. Don R Kellogg
Position: Secretary
Contact Number: 509-522-0940
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Tietan Dental Team clinic are as mentioned below.
NPI Number: 1912124637
NPI Enumeration Date: 20 Apr, 2007
NPI Last Update On: 31 May, 2013
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Tietan Dental Team are as mentioned below.
SpecializationLicense NumberStateStatus
Dentist DE00004225WashingtonPrimary
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
IdentifierTypeStateIssuer
5023346MedicaidWashington
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address: Tietan Dental Team
1602 Penny Ln,
Walla Walla, Washington
Zip: 99362-4477
Phone Number: 509-522-0940
Fax Number: 509-525-9063
Patients can reach Tietan Dental Team at 1602 Penny Ln, Walla Walla, Washington or can call to book an appointment on 509-522-0940. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 11 November, 2024.

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