Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | DE00010783 | WA |
NPI | 1043346851 |
---|---|
Provider Name | Kevin H Sakai |
First Address | Puyallup, WA 98371-4113 |
Second Address | Puyallup, WA 98371-4113 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2007 |
Last Update Date | 22/06/2016 |