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130 131st St S Tacoma WA 98444-4804 | |
(253) 539-7445 | |
(253) 539-7538 |
Full Name | |
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Speciality | Dentist - Pediatric Dentistry |
Location | 130 131st St S, Tacoma, Washington |
Authorized Official Name and Position | Sherwin R. Shinn (DENTAL DIRECTOR) |
Authorized Official Contact | 2535397445 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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130 131st St S Tacoma WA 98444-4804 Ph: (253) 539-7445 | 130 131st St S Tacoma WA 98444-4804 Ph: (253) 539-7445 |
NPI Number | 1265573448 |
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Provider Enumeration Date | 02/09/2007 |
Last Update Date | 06/18/2009 |
Identifier | Type | State | Issuer |
---|---|---|---|
1265573448 | NPI | - | NPPES |
5700109 | Medicaid | WA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223P0221X | Dentist - Pediatric Dentistry | DE00004723 (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 | |
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 | |