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General NPI Number Information
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NPI Number | 1578503157
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Entity Type | Organization
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Legal Business Name | JOHN C. WINSKILL, D.D.S., P.S.
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Dates
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Enumeration Date | 06/08/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2215 N 30TH ST SUIT #104
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City | TACOMA
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State | WA
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Zip | 98403
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Country | US
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Telephone | 253-627-5433
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Fax | 253-627-0443
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Provider Business Mailing Address
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Address Line | 2215 N 30TH ST SUIT #104
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City | TACOMA
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State | WA
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Zip | 98403
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Country | US
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Telephone | 253-627-5433
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Fax | 253-627-0443
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOHN C WINSKILL
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Credential | DDS
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Telephone | 253-627-5433
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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 | 5887
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License Number State | WA
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