| Ronald J Tracy Dds, Ps | |
|
1006 Fryar Ave Ste B Sumner WA 98390-1501 | |
| (253) 863-2995 | |
| (253) 863-3821 |
| Full Name | Ronald J Tracy Dds, Ps |
|---|---|
| Speciality | Clinic/center |
| Location | 1006 Fryar Ave Ste B, Sumner, Washington |
| Authorized Official Name and Position | Ronald John Tracy (PRESIDENT) |
| Authorized Official Contact | 2538632995 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ronald J Tracy Dds, Ps 1006 Fryar Ave Ste B Sumner WA 98390-1501 Ph: (253) 863-2995 | Ronald J Tracy Dds, Ps 1006 Fryar Ave Ste B Sumner WA 98390-1501 Ph: (253) 863-2995 |
| NPI Number | 1700050325 |
|---|---|
| Provider Enumeration Date | 04/15/2008 |
| Last Update Date | 04/15/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700050325 | NPI | - | NPPES |
| 5307202 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 4141 (Washington) | Primary |
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