| Mk Periodontics & Implants | |
|
819 39th Ave Sw Ste B Puyallup WA 98373-3306 | |
| (253) 752-6336 | |
| (253) 752-5655 |
| Full Name | Mk Periodontics & Implants |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 819 39th Ave Sw Ste B, Puyallup, Washington |
| Authorized Official Name and Position | Minou Karbakhsch (OWNER) |
| Authorized Official Contact | 2537526336 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mk Periodontics & Implants 2302 S Union Ave Ste C22 Tacoma WA 98405-1334 Ph: (253) 752-6336 | Mk Periodontics & Implants 819 39th Ave Sw Ste B Puyallup WA 98373-3306 Ph: (253) 752-6336 |
| NPI Number | 1639458722 |
|---|---|
| Provider Enumeration Date | 08/08/2011 |
| Last Update Date | 08/08/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639458722 | NPI | - | NPPES |
| 8579 | Other | WA | WASHINGTON STATE DENTAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | 8579 (Washington) | Primary |
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