Fircrest Family Dental

Organization Active NPI General Practice Dentistry · Fircrest, WA

NPI 1376010652 · NPPES record last updated Oct 25, 2018

Key facts

NPI
1376010652
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
Legal business name
FIRCREST FAMILY DENTAL
Practice address
4040 Orchard St W Ste 200
Fircrest, WA 98466-6615
Phone
(253) 292-0596
NPI assigned
Oct 25, 2018
Organization subpart
No

Authorized official

Name
Nari Lee
Title
Office Manager
Phone
(253) 292-0596

National Provider Directory

Locations

3670 Bridgeport Way W
#B
University Place, WA 98466
Phone (253) 212-3430

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193200000X MULTI-SPECIALTY GROUP
1223G0001X Yes

Addresses

Primary practice location

4040 Orchard St W Ste 200
Fircrest, WA 98466-6615

Mailing address

3670 Bridgeport Way W Unit B
University Place, WA 98466-4413
Phone (253) 212-3430

Other identifiers

IdentifierTypeStateIssuer
1023163425MedicaidWA

Other providers in Fircrest, WA

All providers in Fircrest, WA · General Practice Dentistry in Washington

Sources for this page

Verify at the official NPI Registry.