# TRACY H TAKENAKA DDS MSD PS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Children's Dentistry of Dupont
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144567504
- **Authorized official:** TRACY H TAKENAKA DDS (OWNER/DENTIST)
- **Authorized official phone:** (253) 964-0150

## Contact information

- **Practice address:** 1200 STATION DR STE 180, DUPONT, WA 98327-9804
- **Practice address phone:** (253) 964-0150
- **Practice address fax:** (253) 964-9830
- **Mailing address:** 1200 STATION DR STE 180, DUPONT, WA 98327-9804
- **Mailing address phone:** (253) 964-0150
- **Mailing address fax:** (253) 964-9830

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | DE60023910 | WA | Yes |

## Other

- **Enumeration date:** 01/04/2013
- **Last updated:** 01/04/2013