| |
10510 Gravelly Lake Dr Sw Tacoma WA 98499-5036 | |
(253) 589-7188 | |
(253) 597-4556 |
Full Name | |
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Speciality | Clinic/center - Dental |
Location | 10510 Gravelly Lake Dr Sw, Tacoma, Washington |
Authorized Official Name and Position | David Flentge (CEO) |
Authorized Official Contact | 2535974550 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1148 Broadway Ste 100 Tacoma WA 98402-3518 Ph: (253) 597-4550 | 10510 Gravelly Lake Dr Sw Tacoma WA 98499-5036 Ph: (253) 589-7188 |
NPI Number | 1760602486 |
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Provider Enumeration Date | 04/26/2007 |
Last Update Date | 06/07/2019 |
Identifier | Type | State | Issuer |
---|---|---|---|
1760602486 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | (* (Not Available)) | 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 | |
Bansuk Ju Dds Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2302 S Union Ave Ste A6, Tacoma, WA 98405 Phone: 253-752-4422 | |