MEDICARE: AUBURN DENTURE SERVICES INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122400000X	Denturist	DN00000258	WA

General Provider Information

NPI Number	:	1265979330
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AUBURN DENTURE SERVICES INC.

Provider Business Mailing Address
First Line	:	1268 E MAIN ST
Second Line	:	UNIT 5
City	:	AUBURN
State	:	WA
Zip	:	98002-5748
Country	:	US
Telephone Number	:	253-833-7793
Fax Number	:

Provider Business Practice Location Address
First Line	:	1268 E MAIN ST
Second Line	:	UNIT 5
City	:	AUBURN
State	:	WA
Zip	:	98002-5748
Country	:	US
Telephone Number	:	253-833-7799
Fax Number	:

Authorized Official
Title or Position	:	LICENSED DENTURIST
Name	:	SATOMI HIRAI
Credential	:	LD
Telephone Number	:	253-833-7793

Provider Enumeration Date	:	01/26/2017
Last Update Date	:	01/26/2017

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Directions to “AUBURN DENTURE SERVICES INC. ” Practice Location

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