Individual
DR. TRACY H TAKENAKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
1200 STATION DR STE 180, DUPONT, WA 98327-9804
(253) 964-0150
Mailing address
1200 STATION DR STE 180, DUPONT, WA 98327-9804
(253) 964-0150
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
051468-1
NY
1223P0221X
Pediatric Dentistry
Primary
DE60023910
WA
Other
Enumeration date
12/27/2005
Last updated
08/11/2011
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