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NPI Code Detail

MEDICARE: WILCOX & HENRY DDS PS

MEDICARE: WILCOX & HENRY DDS PS
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
1122300000XDentistDE00010095WA

General Provider Information

NPI Number : 1629523170
Entity Type Code : Organization
Provider Name (Legal Business Name) : WILCOX & HENRY DDS PS
Provider Business Mailing Address
First Line : 7282 STINSON AVE STE D
Second Line :
City : GIG HARBOR
State : WA
Zip : 98335-4930
Country : US
Telephone Number : 253-858-3457
Fax Number :
Provider Business Practice Location Address
First Line : 7282 STINSON AVE STE D
Second Line :
City : GIG HARBOR
State : WA
Zip : 98335-4930
Country : US
Telephone Number : 253-858-3457
Fax Number :
Authorized Official
Title or Position : GENERAL MANAGER
Name : DARILYN HENRY
Credential :
Telephone Number : 253-858-3457
Provider Enumeration Date : 08/24/2016
Last Update Date : 08/24/2016

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