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General NPI Number Information
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NPI Number | 1023204187
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Entity Type | Organization
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Legal Business Name | YANCY T. SIPES DDS PS
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Dates
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Enumeration Date | 09/21/2007
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Last Update Date | 09/21/2007
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Provider Practice Location Address
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Address Line | 31527 3RD AVE
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City | BLACK DIAMOND
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State | WA
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Zip | 98010-9731
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Country | US
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Telephone | 360-886-1300
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Fax | 360-886-9848
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Provider Business Mailing Address
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Address Line | 31527 3RD AVE
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City | BLACK DIAMOND
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State | WA
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Zip | 98010-9731
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Country | US
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Telephone | 360-886-1300
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Fax | 360-886-9848
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. YANCY THEODORE SIPES
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Credential | DDS
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Telephone | 360-886-1300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | DE0009945
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License Number State | WA
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