| Mobile Dental Northwest, Llc | |
|
1622 S Mildred St Suite B Tacoma WA 98465-1610 | |
| (253) 432-4795 | |
| Not Available |
| Full Name | Mobile Dental Northwest, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1622 S Mildred St, Tacoma, Washington |
| Authorized Official Name and Position | Gregory Robert Fisher (VICE PRESIDENT- FINANCE) |
| Authorized Official Contact | 2534324795 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mobile Dental Northwest, Llc 1622 S Mildred St Suite B Tacoma WA 98465-1610 Ph: (253) 432-4795 | Mobile Dental Northwest, Llc 1622 S Mildred St Suite B Tacoma WA 98465-1610 Ph: (253) 432-4795 |
| NPI Number | 1700148152 |
|---|---|
| Provider Enumeration Date | 06/12/2012 |
| Last Update Date | 06/12/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700148152 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 4923 (Washington) | Primary |
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