| J Mark Burnett Dds Ps | |
|
2603 Bridgeport Way W Suite I University Place WA 98466-4724 | |
| (253) 565-1181 | |
| Not Available |
| Full Name | J Mark Burnett Dds Ps |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2603 Bridgeport Way W, University Place, Washington |
| Authorized Official Name and Position | J Mark Burnett (DENTIST) |
| Authorized Official Contact | 2535651181 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| J Mark Burnett Dds Ps 2603 Bridgeport Way W Suite I University Place WA 98466-4724 Ph: (253) 565-1181 | J Mark Burnett Dds Ps 2603 Bridgeport Way W Suite I University Place WA 98466-4724 Ph: (253) 565-1181 |
| NPI Number | 1679679674 |
|---|---|
| Provider Enumeration Date | 09/16/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679679674 | NPI | - | NPPES |
| 5005087 | Medicaid | WA | |
| 0019571 | Other | WA | LABOR & INDUSTRIES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 4322 (Washington) | Primary |
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