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6004 Portal Way Unit A Ferndale WA 98248-8382 | |
(360) 384-3440 | |
(360) 384-6028 |
Full Name | |
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Speciality | Dentist |
Location | 6004 Portal Way Unit A, Ferndale, Washington |
Authorized Official Name and Position | Michael A Sacro (PRESIDENT/DENTIST) |
Authorized Official Contact | 3603843440 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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6004 Portal Way Unit A Ferndale WA 98248-8382 Ph: (360) 384-3440 | 6004 Portal Way Unit A Ferndale WA 98248-8382 Ph: (360) 384-3440 |
NPI Number | 1629498407 |
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Provider Enumeration Date | 04/21/2014 |
Last Update Date | 04/21/2014 |
Identifier | Type | State | Issuer |
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1629498407 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 60453211 (Washington) | Primary |