Pediatric Dental Care Center

LBN: Pediatric Dental Care Center
Pediatric Dental Care Center is an health care organization with primary practice located at 316 Martin Luther King Jr Way Ste 209 , Tacoma WA 98405-4254. The organization recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as the primary health care specialty. Pediatric Dental Care Center can be contacted via phone (253) 627-6023, or through Gibbons, John L. via phone (253) 627-6023.

Contact Information

Primary practice address
316 Martin Luther King Jr Way Ste 209 Tacoma WA 98405-4254
Phone: (253) 627-6023
Fax: (253) 627-4035
Website:
Map and Directions
Authorized official contact:
Name: Gibbons, John L. Doctor of Dental Medicine (DMD)
Phone: (253) 627-6023

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X DE05994 Washington

Profile Details

NPI number 1790947778
LBN Legal business name Pediatric Dental Care Center
DBA Doing business as
Authorized official Gibbons, John L. Doctor of Dental Medicine (DMD)
Entity Organization
Organization subpart 1 No
Enumeration date Jun 30th, 2008
Last updated Jun 30th, 2008 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790947778 NPPES
Washington MEDICAID 5000823

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