Individual
JASON MAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11065 PACIFIC CREST PL NW STE B105, SILVERDALE, WA 98383
(360) 261-6154
Mailing address
11065 PACIFIC CREST PL NW STE B105, SILVERDALE, WA 98383-6607
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE60958190
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/19/2018
Last updated
07/03/2019
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