| NPI | 1396791489 |
|---|---|
| Doing Business As | M STREET DENTAL |
| Entity Type | Organization |
| Authorized Contact | KELLY DIXON Office Manager 253-833-9062 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE00007968) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WA DE00003554) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WA DE00003871) | |
| 1223P0300X Dentist, Periodontics (Licence: WA DE00006154) | |
| 1223G0001X Dentist, General Practice (Licence: WA DE00005696) | |
| 1223G0001X Dentist, General Practice (Licence: WA DE00007992) | |
| 1223G0001X Dentist, General Practice (Licence: WA DE00006607) | |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2018-12-06 |