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Individual

TETSUYA SHIRASUKA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
22625 PACIFIC HWY S, DES MOINES, WA 98198-5110
(206) 878-5665
(206) 870-1504
Mailing address
22625 PACIFIC HWY S, DES MOINES, WA 98198-5110
(206) 878-5665
(206) 870-1504

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
59447
CA
1223G0001X
General Practice Dentistry
DE00010449
WA

Other

Enumeration date
03/22/2007
Last updated
08/25/2017
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