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33801 1st Way S Ste 201 Federal Way WA 98003-6219 | |
(253) 838-4770 | |
Not Available |
Full Name | |
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Speciality | Dentist |
Location | 33801 1st Way S Ste 201, Federal Way, Washington |
Authorized Official Name and Position | Patricio Rafael Dibble (MANAGER/DENTIST) |
Authorized Official Contact | 2538384770 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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33801 1st Way S Ste 201 Federal Way WA 98003-6219 Ph: (253) 838-4770 | 33801 1st Way S Ste 201 Federal Way WA 98003-6219 Ph: (253) 838-4770 |
NPI Number | 1447600507 |
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Provider Enumeration Date | 06/20/2016 |
Last Update Date | 06/20/2016 |
Identifier | Type | State | Issuer |
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1447600507 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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122300000X | Dentist | DE60482588 (Washington) | Primary |
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