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2702 S 42nd St Ste 106 Tacoma WA 98409-7315 | |
(253) 472-7788 | |
(253) 474-9253 |
Full Name | |
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Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
Location | 2702 S 42nd St Ste 106, Tacoma, Washington |
Authorized Official Name and Position | Brent Hassel (OWNER) |
Authorized Official Contact | 2534727788 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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2702 S 42nd St Ste 106 Tacoma WA 98409-7315 Ph: (253) 472-7788 | 2702 S 42nd St Ste 106 Tacoma WA 98409-7315 Ph: (253) 472-7788 |
NPI Number | 1023252947 |
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Provider Enumeration Date | 04/22/2009 |
Last Update Date | 04/22/2009 |
Identifier | Type | State | Issuer |
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1023252947 | NPI | - | NPPES |
5031844 | Medicaid | WA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | DE00007215 (Washington) | Primary |
Olympic Dental & Denture Center, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3720 6th Ave, Suite A, Tacoma, WA 98406 Phone: 253-752-1320 Fax: 253-752-1425 | |
Bansuk Ju Dds Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2302 S Union Ave Ste A6, Tacoma, WA 98405 Phone: 253-752-4422 | |