Provider Demographics
NPI:1154319937
Name:PAL, SONIA (DMD)
Entity Type:Individual
Prefix:DR
First Name:SONIA
Middle Name:
Last Name:PAL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5513 N 35TH ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98407-2589
Mailing Address - Country:US
Mailing Address - Phone:253-761-2169
Mailing Address - Fax:253-761-2169
Practice Address - Street 1:5513 N 35TH ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98407-2589
Practice Address - Country:US
Practice Address - Phone:253-761-2169
Practice Address - Fax:253-761-2169
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA90121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice