| |
3217 Picard Pl Sunnyside WA 98944-8400 | |
(509) 823-4480 | |
(509) 823-4488 |
Full Name | |
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Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
Location | 3217 Picard Pl, Sunnyside, Washington |
Authorized Official Name and Position | Derek Thompson (OWNER) |
Authorized Official Contact | 5098234480 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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4309 W Nob Hill Blvd Yakima WA 98908-3971 Ph: (509) 823-4480 | 3217 Picard Pl Sunnyside WA 98944-8400 Ph: (509) 823-4480 |
NPI Number | 1528350287 |
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Provider Enumeration Date | 05/12/2011 |
Last Update Date | 05/12/2011 |
Identifier | Type | State | Issuer |
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1528350287 | NPI | - | NPPES |
5058441 | Medicaid | WA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 11197 (Washington) | Primary |
Pioneer Specialty Services, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 110 W Yakima Valley Hwy, Sunnyside, WA 98944 Phone: 509-837-2731 Fax: 509-837-2202 | |
Greg Norell, Dds Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2201 E Edison Rd, Ste 2, Sunnyside, WA 98944 Phone: 509-837-3090 | |