Individual
DR. CARL LARUE KNOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
14818 PACIFIC AVE S, TACOMA, WA 98444
(253) 531-0638
(253) 536-7928
Mailing address
14818 PACIFIC AVE S, TACOMA, WA 98444
(253) 531-0638
(253) 536-7928
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5943
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0143
WASHINGTON DENTAL SERVICE
—
01
—
129840361
AMERICAN DENTAL ASSOCIATI
—
05
—
5092507
—
WA
01
—
614482
UNITED CONCORDIA INS
—
01
—
KN707
REGENCE BLUE CROSS BLUE S
—
Enumeration date
02/20/2007
Last updated
07/08/2007
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