Provider Demographics
NPI:1427689421
Name:TRI-CITIES DENTURE STUDIO PLLC
Entity type:Organization
Organization Name:TRI-CITIES DENTURE STUDIO PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTURIST
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:ALSBURY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-788-5910
Mailing Address - Street 1:2984 SEDONA CIR
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99354-2138
Mailing Address - Country:US
Mailing Address - Phone:509-788-5910
Mailing Address - Fax:509-204-8045
Practice Address - Street 1:3909 CREEKSIDE LOOP STE 110
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-4880
Practice Address - Country:US
Practice Address - Phone:509-204-8305
Practice Address - Fax:509-204-8045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-29
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122400000XDental ProvidersDenturistGroup - Single Specialty