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27041 Pacific Hwy S Des Moines WA 98198-9250 | |
| (206) 212-4925 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 27041 Pacific Hwy S, Des Moines, Washington |
| Authorized Official Name and Position | David S Shao (OWNER) |
| Authorized Official Contact | 2062124925 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
27041 Pacific Hwy S Des Moines WA 98198-9250 Ph: (206) 212-4925 | 27041 Pacific Hwy S Des Moines WA 98198-9250 Ph: (206) 212-4925 |
| NPI Number | 1720522360 |
|---|---|
| Provider Enumeration Date | 12/16/2016 |
| Last Update Date | 12/16/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720522360 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DE11005 (Washington) | Primary |
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