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5615 Valley Ave E Tacoma WA 98424-2060 | |
(253) 922-6822 | |
(253) 922-3513 |
Full Name | |
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Speciality | Clinic/center - Dental |
Location | 5615 Valley Ave E, Tacoma, Washington |
Authorized Official Name and Position | Keith Martin Phillips (OWNER) |
Authorized Official Contact | 2539226822 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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5615 Valley Ave E Fife WA 98424-2060 Ph: (253) 922-6822 | 5615 Valley Ave E Tacoma WA 98424-2060 Ph: (253) 922-6822 |
NPI Number | 1396026209 |
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Provider Enumeration Date | 09/06/2011 |
Last Update Date | 01/08/2016 |
Identifier | Type | State | Issuer |
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1396026209 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
261QD0000X | Clinic/center - Dental | (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 | |