| Organization Name: | YANCY T. SIPES DDS PS |
| NPI Number: | 1023204187 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | YANCY THEODORE SIPES (OWNER/DENTIST) |
| Mailing Address: | 31527 3rd Ave Black Diamond |
| State: | WA US |
| Postal Code: | 980109731 |
| Phone Number: | 3608861300 |
| Fax Number: | 3608869848 |
| NPI Enumeration Date: | 09/21/2007 |
| NPI Last Update Date: | 09/21/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | DE0009945 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |