Bonney Lake Family Dental Care | |
21515 State Route 410 E Suite A Bonney Lake WA 98391-4100 | |
(253) 826-9000 | |
(253) 826-0328 |
Full Name | Bonney Lake Family Dental Care |
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Speciality | Dentist - General Practice |
Location | 21515 State Route 410 E, Bonney Lake, Washington |
Authorized Official Name and Position | Otto Julius Hanssen (PRESIDENT) |
Authorized Official Contact | 2538269000 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Bonney Lake Family Dental Care 21515 State Route 410 E Suite A Bonney Lake WA 98391-4100 Ph: (253) 826-9000 | Bonney Lake Family Dental Care 21515 State Route 410 E Suite A Bonney Lake WA 98391-4100 Ph: (253) 826-9000 |
NPI Number | 1699820019 |
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Provider Enumeration Date | 01/24/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
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1699820019 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | (Washington) | Primary |
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