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12165 Pacific Ave S Ste B Tacoma WA 98444-5124 | |
(253) 536-3636 | |
Not Available |
Full Name | |
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Speciality | Dentist - Endodontics |
Location | 12165 Pacific Ave S Ste B, Tacoma, Washington |
Authorized Official Name and Position | Sean Wittmer (PRESIDENT) |
Authorized Official Contact | 2535363636 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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12165 Pacific Ave S Ste B Tacoma WA 98444-5124 Ph: (253) 536-3636 | 12165 Pacific Ave S Ste B Tacoma WA 98444-5124 Ph: (253) 536-3636 |
NPI Number | 1558695056 |
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Provider Enumeration Date | 09/30/2009 |
Last Update Date | 09/30/2009 |
Identifier | Type | State | Issuer |
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1558695056 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223E0200X | Dentist - Endodontics | 7882 (Washington) | Primary |
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