Individual
DR. JUSTIN LEE VANBIBBER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1148 72ND ST E STE B, TACOMA, WA 98404-1705
(801) 231-6682
Mailing address
1148 72ND ST E STE B, TACOMA, WA 98404-1705
(801) 231-6682
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DN1855544
MA
1223P0221X
Pediatric Dentistry
Primary
DE60282727
WA
Other
Enumeration date
10/26/2010
Last updated
09/07/2012
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