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220 Lilly Rd Ne Ste B Olympia WA 98506 | |
| (360) 459-9694 | |
| (360) 459-9657 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 220 Lilly Rd Ne, Olympia, Washington |
| Authorized Official Name and Position | Sherilyn Victoria Malloy (PRESIDENT) |
| Authorized Official Contact | 3604599694 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
220 Lilly Rd Ne Ste B Olympia WA 98506 Ph: (360) 459-9694 | 220 Lilly Rd Ne Ste B Olympia WA 98506 Ph: (360) 459-9694 |
| NPI Number | 1851465090 |
|---|---|
| Provider Enumeration Date | 11/20/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851465090 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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