Organization
TANYA KUSHNER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSY LEE HAGGARD DO (OFFICE MANAGER)
(360) 779-7711
Entity
Organization
Contact information
Practice address
10513 SILVERDALE WAY NW STE 201, SILVERDALE, WA 98383-9499
(360) 779-7711
(360) 779-7732
Mailing address
10513 SILVERDALE WAY NW STE 201, SILVERDALE, WA 98383-9499
(360) 779-7711
(360) 779-7732
Taxonomy
Speciality
Code
Description
License number
State
1223X2210X
Orofacial Pain Dentistry
—
—
261QD0000X
Dental Clinic/Center
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
—
Other
Enumeration date
02/04/2019
Last updated
11/02/2022
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