Provider Demographics
NPI:1174509061
Name:GYARMATI, IMRE (DDS)
Entity Type:Individual
Prefix:DR
First Name:IMRE
Middle Name:
Last Name:GYARMATI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9925 214TH AVE E
Mailing Address - Street 2:SUITE A
Mailing Address - City:BONNEY LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:98391-3910
Mailing Address - Country:US
Mailing Address - Phone:253-863-4594
Mailing Address - Fax:253-863-5061
Practice Address - Street 1:9925 214TH AVE E
Practice Address - Street 2:SUITE A
Practice Address - City:BONNEY LAKE
Practice Address - State:WA
Practice Address - Zip Code:98391-3910
Practice Address - Country:US
Practice Address - Phone:253-863-4594
Practice Address - Fax:253-863-5061
Is Sole Proprietor?:No
Enumeration Date:2005-12-21
Last Update Date:2009-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000074571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
911907892OtherBLDC TAX ID