Daniel J Thacker, D.D.S,P.S.
NPI #1447478474 in Kingston, Washington
Provider Information
- NPI Number
- 1447478474
- Entity Type
- Individual
- Name
- Daniel J Thacker, D.D.S,P.S.
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Dentist - General Practice
- Credential
- D.D.S,P.S.
- Enumeration Date
- Apr 23, 2007
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 26114 ILLINOIS AVENUE
- Address 2
- SUITE A
- City
- Kingston
- State
- Washington
- ZIP Code
- 98346-0149
- Phone
- (360) 297-3392
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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