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NPI 1720391873

NPI 1720391873 : DANIEL R BYRNE DMD ALAN MACKS DMD PS : SILVERDALE, WA

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General NPI Number Information
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    NPI Number           |    1720391873
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    Entity Type          |    Organization 
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    Legal Business Name  |    DANIEL R BYRNE DMD ALAN MACKS DMD PS 
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Dates
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    Enumeration Date     |    07/19/2010
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    Last Update Date     |    07/19/2010
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Provider Practice Location Address
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    Address Line         |    9910 LEVIN RD NW STE 100 
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    City                 |    SILVERDALE
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    State                |    WA
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    Zip                  |    98383-7789
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    Country              |    US
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    Telephone            |    360-698-1990
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    Fax                  |    360-698-2255
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Provider Business Mailing Address
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    Address Line         |    9910 LEVIN RD NW STE 100 
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    City                 |    SILVERDALE
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    State                |    WA
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    Zip                  |    98383-7789
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    Country              |    US
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    Telephone            |    360-698-1990
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    Fax                  |    360-698-2255
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Authorized Official
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    Title or Position    |    OFFICE MANAGER
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    Name                 |     REBECCA L THOMPSON 
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    Credential           |    
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    Telephone            |    360-698-1990
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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       |    6846
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    License Number State |    WA
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