| Children's Dentistry Of Dupont | |
|
1200 Station Dr Ste 180 Dupont WA 98327-9804 | |
| (253) 964-0150 | |
| (253) 964-9830 |
| Full Name | Children's Dentistry Of Dupont |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1200 Station Dr Ste 180, Dupont, Washington |
| Authorized Official Name and Position | Tracy H Takenaka (OWNER/DENTIST) |
| Authorized Official Contact | 2539640150 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Children's Dentistry Of Dupont 1200 Station Dr Ste 180 Dupont WA 98327-9804 Ph: (253) 964-0150 | Children's Dentistry Of Dupont 1200 Station Dr Ste 180 Dupont WA 98327-9804 Ph: (253) 964-0150 |
| NPI Number | 1144567504 |
|---|---|
| Provider Enumeration Date | 01/04/2013 |
| Last Update Date | 01/04/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144567504 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DE60023910 (Washington) | Primary |
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