Larry Heggerness Social Purpose Professional Corporation | |
6720 Fort Dent Way Ste 120 Tukwila WA 98188-2580 | |
(206) 242-4121 | |
(206) 242-4113 |
Full Name | Larry Heggerness Social Purpose Professional Corporation |
---|---|
Speciality | Dentist - Pediatric Dentistry |
Location | 6720 Fort Dent Way Ste 120, Tukwila, Washington |
Authorized Official Name and Position | Larry K Heggerness (PRESIDENT) |
Authorized Official Contact | 2062424121 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Larry Heggerness Social Purpose Professional Corporation 6720 Fort Dent Way Ste 120 Tukwila WA 98188-2580 Ph: (206) 242-4121 | Larry Heggerness Social Purpose Professional Corporation 6720 Fort Dent Way Ste 120 Tukwila WA 98188-2580 Ph: (206) 242-4121 |
NPI Number | 1124365796 |
---|---|
Provider Enumeration Date | 01/15/2013 |
Last Update Date | 01/15/2013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1124365796 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223P0221X | Dentist - Pediatric Dentistry | DE00003686 (Washington) | Primary |
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Lance Timmerman Dmdps Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 7100 Fort Dent Way, Suite #270, Tukwila, WA 98188 Phone: 206-241-5533 Fax: 206-241-5538 | |
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