Organization
WASHINGTON DENTAL CORPORATION, PC
Active
Other names
Puyallup Modern Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DULCE GOMEZ (CREDENTIALING SUPERVISOR)
(714) 845-8701
Entity
Organization
Contact information
Practice address
12005 MERIDIAN E STE 102, PUYALLUP, WA 98373-3423
(253) 214-9293
(253) 267-7368
Mailing address
17000 RED HILL AVE, IRVINE, CA 92614-5626
(714) 845-8500
(303) 952-0892
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
09/11/2019
Last updated
09/11/2019
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