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Organization
WASHINGTON DENTAL CORPORATION, PC
Active
Organization
WASHINGTON DENTAL CORPORATION, PC
Active
Other names
Puyallup Modern Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DULCE GOMEZ (CREDENTIALING SUPERVISOR)
(714) 845-8701
Entity
Organization
Contact information
Practice address
12005 MERIDIAN E STE 102, PUYALLUP, WA 98373-3423
(253) 214-9293
(253) 267-7368
Mailing address
17000 RED HILL AVE, IRVINE, CA 92614-5626
(714) 845-8500
(303) 952-0892
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
NULL
122300000X
Dentist
Primary
—
—
Other
Enumeration date
09/11/2019
Last updated
09/11/2019
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