| Dental Services Of Washington, Inc | |
|
10518 S Tacoma Way Ste B Tacoma WA 98499-5400 | |
| (253) 584-8840 | |
| (253) 584-8511 |
| Full Name | Dental Services Of Washington, Inc |
|---|---|
| Speciality | Denturist |
| Location | 10518 S Tacoma Way Ste B, Tacoma, Washington |
| Authorized Official Name and Position | Bruce Laverne Kizar (PRESIDENT) |
| Authorized Official Contact | 2535848840 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dental Services Of Washington, Inc 10518 S Tacoma Way Ste B Tacoma WA 98499-5400 Ph: (253) 584-8840 | Dental Services Of Washington, Inc 10518 S Tacoma Way Ste B Tacoma WA 98499-5400 Ph: (253) 584-8840 |
| NPI Number | 1942355979 |
|---|---|
| Provider Enumeration Date | 01/23/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942355979 | NPI | - | NPPES |
| 5042619 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
| 122400000X | Denturist | (* (Not Available)) | Primary |
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