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General NPI Number Information
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NPI Number | 1790839827
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Entity Type | Organization
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Legal Business Name | GREGORY J. PLANCICH DDS INC PS
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2312 N 30TH ST STE 201
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City | TACOMA
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State | WA
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Zip | 98403-3356
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Country | US
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Telephone | 253-272-7400
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Fax | 253-404-0687
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Provider Business Mailing Address
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Address Line | 2312 N 30TH ST STE 201
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City | TACOMA
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State | WA
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Zip | 98403-3356
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Country | US
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Telephone | 253-272-7400
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Fax | 253-404-0687
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Authorized Official
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Title or Position | DENTIST
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Name | DR. GREGORY JOHN PLANCICH
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Credential | DDS
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Telephone | 253-272-7400
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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 | 6382
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License Number State | WA
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