# COVINGTON FAMILY DENTISTRY, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Covington Family Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962250936
- **Authorized official:** NICK SUNDIAM (CREDENTIALING MANAGER)
- **Authorized official phone:** (719) 300-5933

## Contact information

- **Practice address:** 17224 SE 272ND ST STE C, COVINGTON, WA 98042-4953
- **Practice address phone:** (253) 630-4400
- **Practice address fax:** (253) 631-2267
- **Mailing address:** 17224 SE 272ND ST STE C, COVINGTON, WA 98042-4953
- **Mailing address phone:** (253) 630-4400
- **Mailing address fax:** (253) 631-2267

## Taxonomy

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

## Other

- **Enumeration date:** 05/07/2024
- **Last updated:** 05/07/2024