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Individual

DR. THOMAS VINCENT PHUNG DUFFY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
717 W. RAILROAD AVE., SHELTON, WA 98584
(360) 426-1664
Mailing address
717 W. RAILROAD AVE., SHELTON, WA 98584

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE60477489
WA
1223G0001X
General Practice Dentistry
DE60477489
WA

Other

Enumeration date
10/01/2014
Last updated
10/01/2014
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