Pediatric Hospital Dentistry | |
317 Martin Luther King Jr Way Tacoma WA 98405-4234 | |
(253) 326-7777 | |
(866) 528-2025 |
Full Name | Pediatric Hospital Dentistry |
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Speciality | Dentist - Pediatric Dentistry |
Location | 317 Martin Luther King Jr Way, Tacoma, Washington |
Authorized Official Name and Position | Shradha Bansal (DENTIST) |
Authorized Official Contact | 4258304773 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Pediatric Hospital Dentistry 615 Windsor Dr Se Sammamish WA 98074-3422 Ph: (253) 326-7777 | Pediatric Hospital Dentistry 317 Martin Luther King Jr Way Tacoma WA 98405-4234 Ph: (253) 326-7777 |
NPI Number | 1356596811 |
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Provider Enumeration Date | 11/25/2008 |
Last Update Date | 11/21/2013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1356596811 | NPI | - | NPPES |
5058490 | Medicaid | WA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223P0221X | Dentist - Pediatric Dentistry | 602840244 (Washington) | Primary |
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