Individual
ALICE KO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
3815 S M ST, TACOMA, WA 98418-3933
(253) 476-8003
Mailing address
5119 104TH ST SW, MUKILTEO, WA 98275-4427
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE60576366
WA
Other
Enumeration date
07/07/2015
Last updated
07/07/2015
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