Jed De La Paz Llc | |
15 Oregon Ave Tacoma WA 98409-7461 | |
(253) 475-0262 | |
Not Available |
Full Name | Jed De La Paz Llc |
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Speciality | Clinic/center - Dental |
Location | 15 Oregon Ave, Tacoma, Washington |
Authorized Official Name and Position | Jed D De La Paz (OWNER DENTIST) |
Authorized Official Contact | 6266418214 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Jed De La Paz Llc 15 Oregon Ave Tacoma WA 98409-7461 Ph: (253) 475-0262 | Jed De La Paz Llc 15 Oregon Ave Tacoma WA 98409-7461 Ph: (253) 475-0262 |
NPI Number | 1366959009 |
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Provider Enumeration Date | 01/03/2018 |
Last Update Date | 01/03/2018 |
Identifier | Type | State | Issuer |
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1366959009 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QD0000X | Clinic/center - Dental | 60772163 (Washington) | Primary |
Olympic Dental & Denture Center, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3720 6th Ave, Suite A, Tacoma, WA 98406 Phone: 253-752-1320 Fax: 253-752-1425 | |
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