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1622 Grove St Marysville WA 98270-4302 | |
(360) 659-5611 | |
(360) 653-9577 |
Full Name | |
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Speciality | Dentist - General Practice |
Location | 1622 Grove St, Marysville, Washington |
Authorized Official Name and Position | Tara L Hudson (PRESIDENT) |
Authorized Official Contact | 3606595611 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1622 Grove St Marysville WA 98270-4302 Ph: (360) 659-5611 | 1622 Grove St Marysville WA 98270-4302 Ph: (360) 659-5611 |
NPI Number | 1750477857 |
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Provider Enumeration Date | 10/05/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1750477857 | NPI | - | NPPES |
5041264 | Medicaid | WA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 8544 (Washington) | Primary |
Xiaoying Deng, Dds, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1246 State Ave Ste C, Marysville, WA 98270 Phone: 360-209-8744 |