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1356474191
JACK EDWARD EHLEN
PUYALLUP, WA
NPI
1356474191
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
122300000X Dentist
(Licence: WA 6157)
Enumeration Date
2007-03-13
Last Update Date
2007-07-08
Business Address
-- JACK EDWARD EHLEN DDS
11208 B 94TH AVE E
PUYALLUP, WA 98373-3663
Phone number: 253-848-4597
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Mailing Address
-- JACK EDWARD EHLEN DDS
11208 B 94TH AVE E
PUYALLUP, WA 98373-3663
Phone number: 253-848-4597
Copy
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