NPI 1467874917

PT. Defiance Dental Clinic and Lab

Organisation Denturist Tacoma, WA

Practice location

Address: 5904 N 45th St, Tacoma, WA 98407-1902
Phone: (253) 238-1783

Authorised official

Name: Sofya V Kochubey
Title: Owner
Phone: (253) 238-1783

Registered specialties (2)

Denturist Primary

Dental Providers Taxonomy 122400000X Licence DN60141899 (WA)

Other Denturist providers in Washington →

Dentist

Dental Providers Taxonomy 122300000X Licence WA8905 (WA)

Other Dentist providers in Washington →

Registry record

NPI: 1467874917
Entity type: Organization
NPI issued: 16 Jan 2014
Record last updated: 16 Jan 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.