Individual
MR. JEFFREY D PRUIETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
719 N 39TH AVE, SUITE 102, YAKIMA, WA 98902-6302
(509) 453-3350
(509) 453-3360
Mailing address
719 N 39TH AVE, SUITE 102, YAKIMA, WA 98902-6302
(509) 453-3350
(509) 453-3860
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE00006385
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5009584
—
WA
Enumeration date
12/27/2006
Last updated
07/08/2007
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