| Spanaway Children's Dentistry | |
|
20709 Mountain Hwy E # 102 Spanaway WA 98387-8580 | |
| (253) 294-7047 | |
| (253) 387-8899 |
| Full Name | Spanaway Children's Dentistry |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 20709 Mountain Hwy E # 102, Spanaway, Washington |
| Authorized Official Name and Position | Kwansoo Lee (DENTIST) |
| Authorized Official Contact | 2532947047 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Spanaway Children's Dentistry 20709 Mountain Hwy E # 102 Spanaway WA 98387-8580 | Spanaway Children's Dentistry 20709 Mountain Hwy E # 102 Spanaway WA 98387-8580 Ph: (253) 294-7047 |
| NPI Number | 1932700671 |
|---|---|
| Provider Enumeration Date | 11/06/2020 |
| Last Update Date | 11/06/2020 |
| Certification Date | 11/06/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932700671 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | () | Primary |
| 261QD0000X | Clinic/center - Dental | () | Secondary |
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