Ivan Puente Roca, RDA

NPI 1851545347 · on the registry since 2008

Practice

Address: 12711 Se Mill Plain Blvd
Vancouver, WA 98684
Phone: (360) 944-2814
Organisation at this address: Kaiser Permanente Dental Care Program
Kaiser Foundation Health Plan Of The Northwest
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 68

Registry record

Primary taxonomy: 126800000X
126800000X
Licence states on file: WA
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2008-11-10

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Washington