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14820 Pacific Ave S Tacoma WA 98444-4655 | |
(832) 628-8604 | |
(281) 855-4511 |
Full Name | |
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Speciality | Dentist - General Practice |
Location | 14820 Pacific Ave S, Tacoma, Washington |
Authorized Official Name and Position | Son Nguyen Bui (OWNER) |
Authorized Official Contact | 8326288604 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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205 E 25th St Houston TX 77008-2523 Ph: (832) 628-8604 | 14820 Pacific Ave S Tacoma WA 98444-4655 Ph: (832) 628-8604 |
NPI Number | 1396264180 |
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Provider Enumeration Date | 09/13/2017 |
Last Update Date | 09/13/2017 |
Identifier | Type | State | Issuer |
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1396264180 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223G0001X | Dentist - General Practice | DE00010979 (Washington) | Primary |
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