Organization
AA BANSAL PLLC
Active
Other names
Pediatric Hospital Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHRADHA BANSAL (DENTIST)
(425) 830-4773
Entity
Organization
Contact information
Practice address
317 MARTIN LUTHER KING JR WAY, TACOMA, WA 98405-4234
(253) 326-7777
(866) 528-2025
Mailing address
615 WINDSOR DR SE, SAMMAMISH, WA 98074-3422
(253) 326-7777
(866) 528-2025
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
602840244
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5058490
—
WA
Enumeration date
11/25/2008
Last updated
11/21/2013
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