Individual
BANSUK JU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6015 CAPITOL BLVD SW, TUMWATER, WA 98501-5268
(360) 943-5420
Mailing address
1635 SW 330TH PL, FEDERAL WAY, WA 98023-6432
(213) 309-1305
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
60762065
WA
Other
Enumeration date
07/03/2017
Last updated
07/03/2017
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