MEDICARE: MR. DALE LAWRENCE PETRICH DDS

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	122300000X	Dentist	DE00004785	WA

General Provider Information

NPI Number	:	1407950595
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DALE LAWRENCE PETRICH DDS

Provider Business Mailing Address
First Line	:	6720 FORT DENT WAY
Second Line	:	SUITE #210
City	:	TUKWILA
State	:	WA
Zip	:	98188
Country	:	US
Telephone Number	:	206-433-5595
Fax Number	:	206-433-0537

Provider Business Practice Location Address
First Line	:	6720 FORT DENT WAY
Second Line	:	SUITE #210
City	:	TUKWILA
State	:	WA
Zip	:	98188
Country	:	US
Telephone Number	:	206-433-5595
Fax Number	:	206-433-0537

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/11/2006
Last Update Date	:	07/08/2007

Similar Medicare Providers

1194675058 — TREVA ESMAILKA
Practice Location Address:

555 ANDOVER PARK W STE 200
TUKWILA, WA
98188-3379

Practice Phone: 877-264-6747
Practice Fax:

1417578543 — NICOLE BAKER
Practice Location Address:

7100 FORT DENT WAY STE 220
TUKWILA, WA
98188-8553

Practice Phone: 425-578-5144
Practice Fax:

1386202539 — SONG PERIODONTICS AND DENTAL IMPLANTS PLLC
Practice Location Address:

411 STRANDER BLVD STE 302
TUKWILA, WA
98188-2924

Practice Phone: 206-575-1086
Practice Fax:

1689533861 — MARIN DEIFEL
Practice Location Address:

6840 FORT DENT WAY STE 350
TUKWILA, WA
98188-8512

Practice Phone: 253-850-2500
Practice Fax: 253-850-2530

1649139825 — CORNEL JOHNSON
Practice Location Address:

6840 FORT DENT WAY STE 350
TUKWILA, WA
98188-8512

Practice Phone: 253-850-2500
Practice Fax:

1083563225 — KAYDEE DEMPSEY
Practice Location Address:

555 ANDOVER PARK W STE 200
TUKWILA, WA
98188-3379

Practice Phone: 877-264-6747
Practice Fax:

1972452118 — JAYDA JONES
Practice Location Address:

555 ANDOVER PARK W STE 200
TUKWILA, WA
98188-3379

Practice Phone: 877-264-6747
Practice Fax:

Directions to “ MR. DALE LAWRENCE PETRICH DDS” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.