# PUYALLUP PEDIATRIC DENTISTRY

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

## Provider details

- **NPI number:** 1821956467
- **Authorized official:** DR. STUART GREGOR HERSEY DDS (MANAGER / OWNER)
- **Authorized official phone:** (253) 864-9889

## Contact information

- **Practice address:** 11201 88TH AVE E STE 120, PUYALLUP, WA 98373-3802
- **Practice address phone:** (253) 864-9889
- **Practice address fax:** (253) 841-6331
- **Mailing address:** 11201 88TH AVE E STE 120, PUYALLUP, WA 98373-3802
- **Mailing address phone:** (253) 864-9889
- **Mailing address fax:** (253) 841-6331

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 01/13/2026
- **Last updated:** 01/13/2026