Individual
JAMES E TELLOIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1930 BLACK LAKE BLVD SW, OLYMPIA, WA 98512-5651
(360) 352-0847
(360) 352-2029
Mailing address
1930 BLACK LAKE BLVD SW, OLYMPIA, WA 98512-5651
(360) 352-0847
(360) 352-2029
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE00006442
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DE00006442
WA STATE LICENSE
VA
Enumeration date
04/03/2007
Last updated
07/08/2007
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