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4801 S 19th St Tacoma WA 98405-1166 | |
(253) 473-0101 | |
(253) 473-6328 |
Full Name | |
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Speciality | Dentist - Endodontics |
Location | 4801 S 19th St, Tacoma, Washington |
Authorized Official Name and Position | Jason J West (CORPORATE OFFICER) |
Authorized Official Contact | 2534730101 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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4801 S 19th St Tacoma WA 98405-1166 Ph: (253) 473-0101 | 4801 S 19th St Tacoma WA 98405-1166 Ph: (253) 473-0101 |
NPI Number | 1508933953 |
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Provider Enumeration Date | 11/29/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
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1508933953 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223E0200X | Dentist - Endodontics | (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 | |