Individual
DR. ANNA REQUA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
24837 104TH AVE SE STE 200, KENT, WA 98030-6800
(253) 850-1234
Mailing address
24837 104TH AVE SE STE 200, KENT, WA 98030-6800
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
60801018
WA
Other
Enumeration date
05/02/2014
Last updated
12/12/2018
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