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15208 Main St E Sumner WA 98390-2638 | |
(253) 891-9100 | |
(253) 863-9368 |
Full Name | |
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Speciality | Dentist - General Practice |
Location | 15208 Main St E, Sumner, Washington |
Authorized Official Name and Position | Angela M Rodriguez (OFFICE MANAGER) |
Authorized Official Contact | 2538919100 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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15208 Main St E Sumner WA 98390-2638 Ph: (253) 891-9100 | 15208 Main St E Sumner WA 98390-2638 Ph: (253) 891-9100 |
NPI Number | 1760793467 |
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Provider Enumeration Date | 06/28/2010 |
Last Update Date | 06/28/2010 |
Identifier | Type | State | Issuer |
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1760793467 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223G0001X | Dentist - General Practice | 5629 (Washington) | Primary |
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