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Individual

MR. RONALD JOHN TRACY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
1006 B FRYAR AVE, SUMNER, WA 98390
(253) 863-2995
(253) 863-3821
Mailing address
1006 B FRYAR AVE, SUMNER, WA 98390
(253) 863-2995
(253) 863-3821

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE00004141
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3072
WDS - DELTA
WA
01
TR0266
REGENCE
WA
Enumeration date
08/24/2006
Last updated
07/08/2007
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