# ANZI DENTAL CENTER 2

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083750327
- **Authorized official:** MS. ROSA MARIA CORTESI (OFFICE MANAGER (CORPORATE OFFICE))
- **Authorized official phone:** (253) 435-4401

## Contact information

- **Practice address:** 20071 STATE ROUTE 410 E, BONNEY LAKE, WA 98391-8460
- **Practice address phone:** (253) 447-4966
- **Practice address fax:** (253) 447-4968
- **Mailing address:** 20071 STATE ROUTE 410 E, BONNEY LAKE, WA 98391-8460
- **Mailing address phone:** (253) 447-4966
- **Mailing address fax:** (253) 447-4968

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | DE00008264 | WA | Yes |

## Other

- **Enumeration date:** 01/30/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 5048319 | — | WA |