Provider Demographics
NPI:1245348366
Name:MARINKOVICH, STEVEN PETER (DDS)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:PETER
Last Name:MARINKOVICH
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 1:5225 TACOMA MALL BLVD
Mailing Address - Street 2:SUITE E 104
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98409
Mailing Address - Country:US
Mailing Address - Phone:253-474-3223
Mailing Address - Fax:253-473-6762
Practice Address - Street 1:5225 TACOMA MALL BLVD
Practice Address - Street 2:SUITE E 104
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98409
Practice Address - Country:US
Practice Address - Phone:253-474-3223
Practice Address - Fax:253-473-6762
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA4767122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist