Provider Demographics
NPI:1346492246
Name:ANTHONY DIRE, D.D.S.,P.S.
Entity Type:Organization
Organization Name:ANTHONY DIRE, D.D.S.,P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANGAGER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:STAHL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-575-1125
Mailing Address - Street 1:411 STRANDER BLVD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:TUKWILA
Mailing Address - State:WA
Mailing Address - Zip Code:98188-2935
Mailing Address - Country:US
Mailing Address - Phone:206-575-1125
Mailing Address - Fax:206-575-2825
Practice Address - Street 1:411 STRANDER BLVD
Practice Address - Street 2:SUITE 206
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98188-2935
Practice Address - Country:US
Practice Address - Phone:206-575-1125
Practice Address - Fax:206-575-2825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-22
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental