Organization
KAI A MAULDING DDS PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KAI ANTONY MAULDING DDS (DENTIST OWNER)
(360) 357-6220
Entity
Organization
Contact information
Practice address
1212 E 4TH AVE, OLYMPIA, WA 98506
(360) 357-6220
(360) 352-5412
Mailing address
1212 E 4TH AVE, OLYMPIA, WA 98506
(360) 357-6220
(360) 352-5412
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8811
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0205264
L & I
WA
01
—
11181
WASHINGTON DENTAL SERVICE
WA
01
—
5047212
DSHS
WA
Enumeration date
12/06/2006
Last updated
08/22/2020
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