Provider Demographics
NPI:1922327204
Name:TOMSON P MAR FAMILY DENTISTRY.
Entity Type:Organization
Organization Name:TOMSON P MAR FAMILY DENTISTRY.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TOMSON
Authorized Official - Middle Name:PING
Authorized Official - Last Name:MAR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:206-622-3840
Mailing Address - Street 1:318 6TH AVE S
Mailing Address - Street 2:SUITE #108
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-2750
Mailing Address - Country:US
Mailing Address - Phone:206-622-3840
Mailing Address - Fax:
Practice Address - Street 1:318 6TH AVE S
Practice Address - Street 2:SUITE #108
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2750
Practice Address - Country:US
Practice Address - Phone:206-622-3840
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-25
Last Update Date:2010-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA55941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty