| |
1550 S Union Ave Ste 250 Tacoma WA 98405-1946 | |
(253) 572-4601 | |
(253) 572-4769 |
Full Name | |
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Speciality | Dentist |
Location | 1550 S Union Ave Ste 250, Tacoma, Washington |
Authorized Official Name and Position | Peter David Gauger (OWNER) |
Authorized Official Contact | 2535724601 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1550 S Union Ave Ste 250 Tacoma WA 98405-1946 Ph: (253) 572-4601 | 1550 S Union Ave Ste 250 Tacoma WA 98405-1946 Ph: (253) 572-4601 |
NPI Number | 1225437619 |
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Provider Enumeration Date | 08/21/2014 |
Last Update Date | 02/08/2024 |
Medicare PECOS PAC ID | 4183990237 |
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Medicare Enrollment ID | O20171018000806 |
Identifier | Type | State | Issuer |
---|---|---|---|
1225437619 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223S0112X | Dentist - Oral And Maxillofacial Surgery | DE 60216311 (Washington) | Primary |
Provider Name | Peter David Gauger |
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Provider Type | Practitioner - Oral Surgery |
Provider Identifiers | NPI Number: 1730310426 PECOS PAC ID: 1355583253 Enrollment ID: I20171018000878 |
Olympic Dental & Denture Center, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3720 6th Ave, Suite A, Tacoma, WA 98406 Phone: 253-752-1320 Fax: 253-752-1425 | |
Bansuk Ju Dds Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2302 S Union Ave Ste A6, Tacoma, WA 98405 Phone: 253-752-4422 | |