| Pediatric Dental Associates | |
|
6015 100th St Sw Lakewood WA 98499-2754 | |
| (253) 582-2626 | |
| (253) 588-0117 |
| Full Name | Pediatric Dental Associates |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 6015 100th St Sw, Lakewood, Washington |
| Authorized Official Name and Position | Daniel H Cook (OWNER) |
| Authorized Official Contact | 2535822626 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatric Dental Associates 6015 100th St Sw Lakewood WA 98499-2754 Ph: (253) 582-2626 | Pediatric Dental Associates 6015 100th St Sw Lakewood WA 98499-2754 Ph: (253) 582-2626 |
| NPI Number | 1528186137 |
|---|---|
| Provider Enumeration Date | 03/26/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528186137 | NPI | - | NPPES |
| 5028071 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 3793 (Washington) | Primary |
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