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Organization

THOMAS HENRY DDS PS DBA CANYON ORTHODONTICS

Active
Other names
Canyon Orthodontics
Organization subpart
No

Provider details

NPI number
Authorized official
DR. THOMAS HENRY DDS (OWNER/DENTIST)
(253) 256-4000
Entity
Organization

Contact information

Practice address
5620 112TH ST E, SUITE 255, PUYALLUP, WA 98373-3206
(253) 256-4000
(253) 770-9638
Mailing address
5620 112TH ST E, SUITE 255, PUYALLUP, WA 98373-3206
(253) 256-4000
(253) 770-9638

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
5432
WA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
10731
WA

Other

Enumeration date
06/08/2015
Last updated
06/08/2015
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