Chacon, Guillermo Enrique
Chacon, Guillermo Enrique is an sole proprietor health care provider with primary practice located at 2910 S Meridian Suite 120, Puyallup WA 98373-1585. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Chacon, Guillermo Enrique can be contacted via phone (253) 445-0022.Contact Information
Primary practice address
2910 S Meridian Suite 120
Puyallup WA 98373-1585
Phone: (253) 445-0022
Fax: (253) 445-0979
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | DE 60063175 | Washington |
Profile Details
| NPI number | 1619047511 |
|---|---|
| LBN Legal business name | Chacon, Guillermo Enrique |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 8th, 2006 |
| Last updated | Apr 10th, 2017 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1619047511 | NPPES |
| Washington | MEDICAID | 2237985 | |
| Washington | Other | 311203750028 | |
| Washington | Other | 2237985 | |
| Washington | Other | CH4046621 |
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