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Organization

PUYALLUP DENTAL, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. TRAVIS JOHN PROBST D.D.S. (DENTIST)
(253) 475-9120
Entity
Organization

Contact information

Practice address
16420 MERIDIAN E, PUYALLUP, WA 98375-2514
(253) 475-9120
(253) 475-9284
Mailing address
16420 MERIDIAN E, PUYALLUP, WA 98375-2514
(253) 475-9120
(253) 475-9284

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE 60198294
WA

Other

Enumeration date
11/01/2012
Last updated
11/01/2012
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