Healthcare Provider Details

I. General information

NPI: 1013147297
Provider Name (Legal Business Name): ANGELA LEIGH DUNN DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2009
Last Update Date: 07/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8012 112TH STREET CT E SUITE #320
PUYALLUP WA
98373-7856
US

IV. Provider business mailing address

8012 112TH STREET CT E SUITE #320
PUYALLUP WA
98373-7856
US

V. Phone/Fax

Practice location:
  • Phone: 253-848-2331
  • Fax: 253-840-4033
Mailing address:
  • Phone: 253-848-2331
  • Fax: 253-840-4033

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDE60098994
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: