# DENTAL PROFESSIONALS OF WASHINGTON, QUIRT, MONGRAIN, GIBREE, PC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** DENTAL PROFESSIONALS OF WASHINGTON, QUIRT, MONGRAIN, GIBREE, PC
- **Other names:** Dental Care of South Puyallup
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1679271324
- **Legal business name:** DENTAL PROFESSIONALS OF WASHINGTON, QUIRT, MONGRAIN, GIBREE, PC
- **Authorized official:** BELINDA HUERTA (CREDENTIALING COORDINATOR)
- **Authorized official phone:** (217) 540-2100

## Contact information

- **Practice address:** 15514 MERIDIAN E, PUYALLUP, WA 98375-9513
- **Practice address phone:** (253) 268-1215
- **Practice address fax:** (253) 268-1213
- **Mailing address:** 15514 MERIDIAN E, PUYALLUP, WA 98375-9513
- **Mailing address phone:** (253) 268-1215
- **Mailing address fax:** (253) 268-1213

## Taxonomy

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

## Other

- **Enumeration date:** 02/22/2023
- **Last updated:** 02/22/2023