Provider Demographics
NPI:1508933953
Name:DRS WEST & WEST PS
Entity Type:Organization
Organization Name:DRS WEST & WEST PS
Other - Org Name:CENTER FOR ENDODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORPORATE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:J
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:253-473-0101
Mailing Address - Street 1:4801 S 19TH ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-1166
Mailing Address - Country:US
Mailing Address - Phone:253-473-0101
Mailing Address - Fax:253-473-6328
Practice Address - Street 1:4801 S 19TH ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-1166
Practice Address - Country:US
Practice Address - Phone:253-473-0101
Practice Address - Fax:253-473-6328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty