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General NPI Number Information
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NPI Number | 1336404789
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Entity Type | Individual
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Provider Name | KULWANT SINGH VERRAICH DENTIST
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Gender | Male
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Dates
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Enumeration Date | 07/11/2012
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Last Update Date | 07/11/2012
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Provider Practice Location Address
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Address Line | 22613 PACIFIC HWY S SUITE # 301
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City | DES MOINES
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State | WA
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Zip | 98198-5110
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Country | US
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Telephone | 206-824-7000
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Fax | 206-824-4888
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Provider Business Mailing Address
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Address Line | 22613 PACIFIC HWY. SOUTH SUITE # 301
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City | DES MOINES
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State | WA
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Zip | 98198
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Country | US
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Telephone | 206-824-7000
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Fax | 206-824-4888
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | DE 00008393
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License Number State | WA
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