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General NPI Number Information
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NPI Number | 1801041876
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Entity Type | Organization
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Legal Business Name | DR. WILLIAM G. DEDGE, DC, INC., PS
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Dates
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Enumeration Date | 11/18/2008
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Last Update Date | 12/20/2012
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Provider Practice Location Address
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Address Line | 721 M ST NE STE 105
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City | AUBURN
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State | WA
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Zip | 98002-4503
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Country | US
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Telephone | 253-939-9599
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Fax | 253-804-5655
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Provider Business Mailing Address
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Address Line | 721 M ST NE STE 105
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City | AUBURN
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State | WA
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Zip | 98002-4503
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Country | US
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Telephone | 253-939-9599
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Fax | 253-804-5655
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Authorized Official
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Title or Position | OWNER/DOCTOR
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Name | DR. WILLIAM GEORGE DEDGE
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Credential | DC
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Telephone | 253-939-9599
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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