| Ellen Polsky Dds | |
|
9317 113th St E Ste A Puyallup WA 98373-3876 | |
| (253) 848-7000 | |
| Not Available |
| Full Name | Ellen Polsky Dds |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 9317 113th St E Ste A, Puyallup, Washington |
| Authorized Official Name and Position | Debbie Loree (PRACTICE MANAGEMENT) |
| Authorized Official Contact | 5035510865 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ellen Polsky Dds 9317 113th St E Ste A Puyallup WA 98373-3876 Ph: (253) 848-7000 | Ellen Polsky Dds 9317 113th St E Ste A Puyallup WA 98373-3876 Ph: (253) 848-7000 |
| NPI Number | 1538460571 |
|---|---|
| Provider Enumeration Date | 11/08/2010 |
| Last Update Date | 11/08/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538460571 | NPI | - | NPPES |
| 1055311 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 10757 (Washington) | Primary |
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