Organization
HACKNEY FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KYLE HOUSTON HACKNEY DDS (PARTNER/DENTIST)
(360) 426-1676
Entity
Organization
Contact information
Practice address
1051 SE STATE ROUTE 3, SHELTON, WA 98584-7117
(360) 426-1676
(360) 427-4303
Mailing address
PO BOX 398, SHELTON, WA 98584-0398
(360) 426-1676
(360) 427-4304
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DE60035243
WA
Other
Enumeration date
02/19/2009
Last updated
02/19/2009
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