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General NPI Number Information
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NPI Number | 1235547175
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Entity Type | Organization
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Legal Business Name | JEAN-PAUL BANH, DDS, PLLC
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Dates
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Enumeration Date | 07/23/2014
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Last Update Date | 07/23/2014
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Provider Practice Location Address
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Address Line | 110 D ST SE
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City | AUBURN
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State | WA
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Zip | 98002-5528
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Country | US
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Telephone | 253-397-4030
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Fax |
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Provider Business Mailing Address
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Address Line | 110 D ST SE
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City | AUBURN
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State | WA
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Zip | 98002-5528
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Country | US
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Telephone | 253-397-4030
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Fax |
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Authorized Official
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Title or Position | DENTIST/MANAGING MEMBER
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Name | JEAN-PAUL BANH
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Credential | D.D.S.
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Telephone | 253-397-4030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DE60475803
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License Number State | WA
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