| Robert E. Tanner, DDS, PLLC | |
|
22516 Se 64th Pl Ste. #120 Issaquah WA 98027-5379 | |
| (425) 392-8882 | |
| (425) 392-9101 |
| Full Name | Robert E. Tanner, DDS, PLLC |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 22516 Se 64th Pl, Issaquah, Washington |
| Authorized Official Name and Position | Robert E. Tanner (DENTIST) |
| Authorized Official Contact | 4253928882 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Robert E. Tanner, DDS, PLLC 22516 Se 64th Pl Ste. #120 Issaquah WA 98027-5379 Ph: (425) 392-8882 | Robert E. Tanner, DDS, PLLC 22516 Se 64th Pl Ste. #120 Issaquah WA 98027-5379 Ph: (425) 392-8882 |
| NPI Number | 1871648519 |
|---|---|
| Provider Enumeration Date | 01/24/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871648519 | NPI | - | NPPES |
| 5017793 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DE00006439 (Washington) | Primary |
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