Organization
BANSUK JU DDS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BANSUK JU DDS (OWNER)
(213) 309-1305
Entity
Organization
Contact information
Practice address
2302 S UNION AVE STE A6, TACOMA, WA 98405-1332
(253) 752-4422
Mailing address
1635 SW 330TH PL, FEDERAL WAY, WA 98023-6432
(213) 309-1305
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
12/11/2020
Last updated
12/11/2020
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