Provider Demographics
NPI:1386622066
Name:THE DENTIST INC
Entity type:Organization
Organization Name:THE DENTIST INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:L
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:360-491-1860
Mailing Address - Street 1:3929 MARTIN WAY E
Mailing Address - Street 2:STE D AND E
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98506-5200
Mailing Address - Country:US
Mailing Address - Phone:360-491-1860
Mailing Address - Fax:360-491-8101
Practice Address - Street 1:3929 MARTIN WAY E
Practice Address - Street 2:STE D AND E
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-5200
Practice Address - Country:US
Practice Address - Phone:360-491-1860
Practice Address - Fax:360-491-8101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA7172122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
09665OtherWASHINGTON DENTAL INS.
818702OtherUNITED CONCORDIA