| Bonney Lake Family Dentistry, Pllc | |
|
21515 State Route 410 E Ste A Bonney Lake WA 98391-4100 | |
| (253) 826-9000 | |
| (253) 826-0328 |
| Full Name | Bonney Lake Family Dentistry, Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 21515 State Route 410 E Ste A, Bonney Lake, Washington |
| Authorized Official Name and Position | Nick Sundiam (CREDENTIALING MANAGER) |
| Authorized Official Contact | 7193005933 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bonney Lake Family Dentistry, Pllc 21515 State Route 410 E Ste A Bonney Lake WA 98391-4100 Ph: (253) 826-9000 | Bonney Lake Family Dentistry, Pllc 21515 State Route 410 E Ste A Bonney Lake WA 98391-4100 Ph: (253) 826-9000 |
| NPI Number | 1548018526 |
|---|---|
| Provider Enumeration Date | 05/07/2024 |
| Last Update Date | 05/07/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548018526 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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