| Kids Choice Dental | |
|
9317 113th St E Suite A Puyallup WA 98373-3876 | |
| (253) 848-7000 | |
| (253) 604-0598 |
| Full Name | Kids Choice Dental |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 9317 113th St E, Puyallup, Washington |
| Authorized Official Name and Position | Mahadeed S Virk (OWNER OPERATOR) |
| Authorized Official Contact | 2538487000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kids Choice Dental 9317 113th St E Suite A Puyallup WA 98373-3876 Ph: (253) 848-7000 | Kids Choice Dental 9317 113th St E Suite A Puyallup WA 98373-3876 Ph: (253) 848-7000 |
| NPI Number | 1891158861 |
|---|---|
| Provider Enumeration Date | 03/29/2016 |
| Last Update Date | 04/01/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891158861 | NPI | - | NPPES |
| 2010685 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 603591386 (Washington) | Primary |
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