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Kalispel Tribe of Indians — NPI 1083980080, Cusick, WA | NPI Central

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NPI 1083980080

OrganizationActive

Kalispel Tribe of Indians

NPI 1083980080 · Dentist · Cusick, WA

Provider details

NPI number: 1083980080
Entity type: Organization
Primary specialty: DentistDental Providers
Organization subpart: No
Authorized official: Tracy Birdtail, Am(509) 447-7112
License: DE00009801 (WA)

Specialties & taxonomies

DentistPrimary122300000XLicense DE00009801 (WA)
Dental Providers

Practice location

1821 Leclerc Rd N Ste 1

Cusick, WA 99119-5015

Phone: (509) 447-7111

Fax: (509) 445-1152

Approximate (ZIP-level) locationGet directions

More WA providers

Mailing address

Po Box 67

Usk, WA 99180-0067

Other names (DBA / former)

Doing business as: Camas Center Dental Clinic
Doing business as: Camas Center Dental Clinic

Registry dates

Enumerated: 2012-03-24
Last updated: 2023-09-13
Certified: 2023-09-13

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.