Provider Demographics
NPI:1417565672
Name:ARNETT, GIDEON MICHAEL (DMD)
Entity type:Individual
Prefix:DR
First Name:GIDEON
Middle Name:MICHAEL
Last Name:ARNETT
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1312 S SEVIER RD
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:WA
Mailing Address - Zip Code:98642-7692
Mailing Address - Country:US
Mailing Address - Phone:360-949-5437
Mailing Address - Fax:
Practice Address - Street 1:500 COLUMBIA ST STE B
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:WA
Practice Address - Zip Code:98674-8491
Practice Address - Country:US
Practice Address - Phone:360-225-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-14
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE610712681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice