Provider Demographics
NPI:1215128301
Name:RICK K OUHL D.D.S.,P.S.
Entity type:Organization
Organization Name:RICK K OUHL D.D.S.,P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICK
Authorized Official - Middle Name:K
Authorized Official - Last Name:OUHL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:253-537-6511
Mailing Address - Street 1:11517 PACIFIC AVE S
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98444-5535
Mailing Address - Country:US
Mailing Address - Phone:253-537-6511
Mailing Address - Fax:253-539-7554
Practice Address - Street 1:11517 PACIFIC AVE S
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98444-5535
Practice Address - Country:US
Practice Address - Phone:253-537-6511
Practice Address - Fax:253-539-7554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA54671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty