Organization
TOOTH FAIRIES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NANCY C ALLEMAN RDH BS (CEO)
(253) 905-1682
Entity
Organization
Contact information
Practice address
146 CORMORANT DR, STEILACOOM, WA 98388-1720
(253) 905-1692
Mailing address
146 CORMORANT DR, STEILACOOM, WA 98388-1720
(253) 905-1692
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH00001654
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5902002
—
WA
Enumeration date
06/02/2009
Last updated
06/02/2009
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