| Hawks Prairie Pediatric Dentistry/ West Olympia Kids Dentistry | |
|
8685 Martin Way E Ste 101 Lacey WA 98516-5857 | |
| (360) 489-1406 | |
| (360) 491-1270 |
| Full Name | Hawks Prairie Pediatric Dentistry/ West Olympia Kids Dentistry |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 8685 Martin Way E Ste 101, Lacey, Washington |
| Authorized Official Name and Position | Kenneth A Bloch (ATTORNEY) |
| Authorized Official Contact | 2066823840 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hawks Prairie Pediatric Dentistry/ West Olympia Kids Dentistry 8685 Martin Way E Ste 101 Lacey WA 98516-5857 Ph: (360) 489-1406 | Hawks Prairie Pediatric Dentistry/ West Olympia Kids Dentistry 8685 Martin Way E Ste 101 Lacey WA 98516-5857 Ph: (360) 489-1406 |
| NPI Number | 1134564032 |
|---|---|
| Provider Enumeration Date | 05/06/2013 |
| Last Update Date | 09/21/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134564032 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | DE60112868 (Washington) | Primary |
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