| Jed De La Paz Llc | |
|
15 Oregon Ave Tacoma WA 98409-7461 | |
| (253) 475-0262 | |
| Not Available |
| Full Name | Jed De La Paz Llc |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| Provider Enumeration Date | 01/03/2018 |
| Last Update Date | 01/03/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366959009 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 60772163 (Washington) | Primary |
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