Organization
STEVEN J URBACK DDS MAGD PS
Active
Other names
Puyallup Valley Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREN GIDEON (OFFICE MANAGER)
(253) 841-3173
Entity
Organization
Contact information
Practice address
2921 5TH AVE NE, SUITE 110, PUYALLUP, WA 98372-7044
(253) 841-3173
Mailing address
2921 5TH AVE NE, SUITE 110, PUYALLUP, WA 98372-7044
(253) 841-3173
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5496
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5047048
—
WA
Enumeration date
03/27/2007
Last updated
06/27/2008
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