Provider Demographics
NPI:1871015040
Name:AGATA A PIKULA DDS PLLC
Entity Type:Organization
Organization Name:AGATA A PIKULA DDS PLLC
Other - Org Name:THE CENTER FOR CHILDREN'S DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AGATA
Authorized Official - Middle Name:AGNIESZKA
Authorized Official - Last Name:PIKULA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:253-697-0201
Mailing Address - Street 1:1420 3RD ST SE # 104
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98372-3730
Mailing Address - Country:US
Mailing Address - Phone:253-697-0201
Mailing Address - Fax:
Practice Address - Street 1:1420 3RD ST SE # 104
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98372-3730
Practice Address - Country:US
Practice Address - Phone:253-697-0201
Practice Address - Fax:253-697-0399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60591198261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental