| |
3402 S 18th St Suite B Tacoma WA 98405-1903 | |
(253) 627-5027 | |
(253) 383-7747 |
Full Name | |
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Speciality | Dentist - Pediatric Dentistry |
Location | 3402 S 18th St, Tacoma, Washington |
Authorized Official Name and Position | Mahadeep S Virk (OWNER OPERATOR) |
Authorized Official Contact | 2536275027 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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3402 S 18th St Suite B Tacoma WA 98405-1903 Ph: (253) 627-5027 | 3402 S 18th St Suite B Tacoma WA 98405-1903 Ph: (253) 627-5027 |
NPI Number | 1942663927 |
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Provider Enumeration Date | 03/29/2016 |
Last Update Date | 03/29/2016 |
Identifier | Type | State | Issuer |
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1942663927 | NPI | - | NPPES |
2010685 | Medicaid | WA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223P0221X | Dentist - Pediatric Dentistry | 603591384 (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 | |