| |
205 117th St S Tacoma WA 98444-5409 | |
(253) 531-7111 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Dental |
Location | 205 117th St S, Tacoma, Washington |
Authorized Official Name and Position | Sang Yoon Shin (OWNER) |
Authorized Official Contact | 2535317111 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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205 117th St S Tacoma WA 98444-5409 Ph: (253) 531-7111 | 205 117th St S Tacoma WA 98444-5409 Ph: (253) 531-7111 |
NPI Number | 1699942946 |
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Provider Enumeration Date | 05/14/2008 |
Last Update Date | 05/14/2008 |
Identifier | Type | State | Issuer |
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1699942946 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QD0000X | Clinic/center - Dental | 9744 (Washington) | Primary |
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