IndividualActive
Jennifer Bantugan, EFDA, EFODA, RDA
NPI 1770355307 · Dental Assistant · Vancouver, WA
Provider details
- NPI number
- 1770355307
- Entity type
- Individual
- Primary specialty
- Dental AssistantDental Providers
- Credential
- EFDA, EFODA, RDA
- Sex
- Female
- Sole proprietor
- No
Specialties & taxonomies
Dental Providers
Practice location
12711 Se Mill Plain Blvd
Vancouver, WA 98684-6053
Phone: (360) 449-1610
Approximate (ZIP-level) locationGet directions
Mailing address
12711 Se Mill Plain Blvd
Vancouver, WA 98684-6053
Registry dates
- Enumerated
- 2023-10-26
- Last updated
- 2023-10-26
- Certified
- 2023-10-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.