Organization
KARBAKHSCH PERIODONTICS & IMPLANTS - SOUTH PLLC
Active
Parent organization
KARBAKHSCH PERIODONTICS & IMPLANTS
Other names
MK Periodontics & Implants
Organization subpart
Yes
Provider details
NPI number
Legal business name
KARBAKHSCH PERIODONTICS & IMPLANTS
Authorized official
DR. MINOU KARBAKHSCH DDS, MSD (OWNER)
(253) 752-6336
Entity
Organization
Contact information
Practice address
819 39TH AVE SW STE B, PUYALLUP, WA 98373-3306
(253) 752-6336
(253) 752-5655
Mailing address
2302 S UNION AVE STE C22, TACOMA, WA 98405-1334
(253) 752-6336
(253) 752-5655
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
8579
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8579
WASHINGTON STATE DENTAL LICENSE
WA
Enumeration date
08/08/2011
Last updated
08/08/2011
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