Provider First Line Business Practice Location Address:
26228 PACIFIC HWY S
Provider Second Line Business Practice Location Address:
MIDWAY DENTAL CENTER
Provider Business Practice Location Address City Name:
KENT
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98032-6934
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-941-1889
Provider Business Practice Location Address Fax Number:
253-941-3363
Provider Enumeration Date:
05/14/2007