Mahoney, Brian E

Mahoney, Brian E is an individual health care provider with primary practice located at 3512 Main St , Vancouver WA 98663-2224. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Mahoney, Brian E can be contacted via phone (360) 696-2513.

Contact Information

Primary practice address
3512 Main St Vancouver WA 98663-2224
Phone: (360) 696-2513
Fax: (360) 696-0268
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 6106 Washington

Profile Details

NPI number 1356346639
LBN Legal business name Mahoney, Brian E
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2005
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356346639 NPPES
Washington MEDICAID 5002266

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