| Tenino Family Dental Center | |
|
872 Sussex Ave E Tenino WA 98589-9287 | |
| (360) 264-2353 | |
| Not Available |
| Full Name | Tenino Family Dental Center |
|---|---|
| Speciality | Dentist |
| Location | 872 Sussex Ave E, Tenino, Washington |
| Authorized Official Name and Position | Suzanne Kluh Winans (OWNER PARTNER) |
| Authorized Official Contact | 3602642353 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tenino Family Dental Center Po Box 734 Tenino WA 98589-0734 Ph: (360) 264-2353 | Tenino Family Dental Center 872 Sussex Ave E Tenino WA 98589-9287 Ph: (360) 264-2353 |
| NPI Number | 1558587170 |
|---|---|
| Provider Enumeration Date | 04/18/2007 |
| Last Update Date | 05/10/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558587170 | NPI | - | NPPES |
| 5024740 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 9980 (Washington) | Primary |