# KEN M. SHOU DDS INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Surprise Lake Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073835195
- **Authorized official:** DR. KEN M SHOU DDS (PRESIDENT)
- **Authorized official phone:** (253) 922-5401

## Contact information

- **Practice address:** 900 MERIDIAN E STE 27, STE.27, MILTON, WA 98354-7003
- **Practice address phone:** (253) 922-5401
- **Practice address fax:** (253) 926-8048
- **Mailing address:** 900 MERIDIAN E STE 27, STE.27, MILTON, WA 98354-7003
- **Mailing address phone:** (253) 922-5401
- **Mailing address fax:** (253) 926-8048

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 02/16/2010
- **Last updated:** 02/16/2010