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4538 Martin Way E Ste 103 Olympia WA 98516-5387 | |
(360) 493-1866 | |
Not Available |
Full Name | |
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Speciality | Dentist |
Location | 4538 Martin Way E Ste 103, Olympia, Washington |
Authorized Official Name and Position | Suneet S Bath (OWNER) |
Authorized Official Contact | 3604931866 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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4538 Martin Way E Ste 103 Olympia WA 98516-5387 Ph: (360) 493-1866 | 4538 Martin Way E Ste 103 Olympia WA 98516-5387 Ph: (360) 493-1866 |
NPI Number | 1346796141 |
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Provider Enumeration Date | 08/31/2016 |
Last Update Date | 06/11/2020 |
Medicare PECOS PAC ID | 0446678262 |
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Medicare Enrollment ID | O20200910002602 |
Identifier | Type | State | Issuer |
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1346796141 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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122300000X | Dentist | 9299 (Washington) | Primary |
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