Individual
MARCO OKTOVIATOR WAWORUNTU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5003 TACOMA MALL BLVD STE 103, TACOMA, WA 98409-7120
(253) 881-8780
Mailing address
5003 TACOMA MALL BLVD, TACOMA, WA 98409-7120
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
61565869
WA
Other
Enumeration date
03/08/2023
Last updated
08/14/2024
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