Individual
KIMANDEEP KAUR RAKED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10510 GRAVELLY LAKE DR SW, TACOMA, WA 98499-5036
(253) 597-4550
Mailing address
1148 BROADWAY STE 100, TACOMA, WA 98402-3518
(253) 597-4550
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
60674956
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/31/2016
Last updated
03/15/2021
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