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General NPI Number Information
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NPI Number | 1790004869
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Entity Type | Organization
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Legal Business Name | DODOBARAS,D.D.S.,P.S.
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Dates
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Enumeration Date | 05/27/2010
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Last Update Date | 05/27/2010
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Provider Practice Location Address
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Address Line | 33515 10TH PL S STE 12
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City | FEDERAL WAY
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State | WA
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Zip | 98003-7300
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Country | US
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Telephone | 253-838-9996
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Fax | 253-815-9462
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Provider Business Mailing Address
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Address Line | 33515 10TH PL. S. SUITE #12
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City | FEDERAL WAY
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State | WA
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Zip | 98003
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Country | US
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Telephone | 253-838-9996
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Fax | 253-815-9462
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. SHAWNA MARIE CAREY
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Credential |
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Telephone | 253-838-9996
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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 | DE00003460
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License Number State | WA
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