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1950 S Cedar St Ste C Tacoma WA 98405-2315 | |
(253) 383-1471 | |
(253) 627-3753 |
Full Name | |
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Speciality | Dentist - Oral And Maxillofacial Surgery |
Location | 1950 S Cedar St Ste C, Tacoma, Washington |
Authorized Official Name and Position | Krista M Smith (OFFICE MANAGER) |
Authorized Official Contact | 2533831471 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1950 S Cedar St Ste C Tacoma WA 98405-2315 Ph: (253) 383-1471 | 1950 S Cedar St Ste C Tacoma WA 98405-2315 Ph: (253) 383-1471 |
NPI Number | 1366520207 |
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Provider Enumeration Date | 11/01/2006 |
Last Update Date | 12/29/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1366520207 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223S0112X | Dentist - Oral And Maxillofacial Surgery | (Washington) | Primary |
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