# JED DE LA PAZ LLC

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

## Provider details

- **NPI number:** 1366959009
- **Authorized official:** DR. JED D DE LA PAZ DDS (OWNER DENTIST)
- **Authorized official phone:** (626) 641-8214

## Contact information

- **Practice address:** 15 OREGON AVE, TACOMA, WA 98409-7461
- **Practice address phone:** (253) 475-0262
- **Mailing address:** 15 OREGON AVE, TACOMA, WA 98409-7461
- **Mailing address phone:** (253) 475-0262

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 60772163 | WA | Yes |

## Other

- **Enumeration date:** 01/03/2018
- **Last updated:** 01/03/2018