Broughton Dunn PLLC
Dentist, General Practice in Puyallup, WA. Organization (NPI-2).
NPI number1104749290
StatusActive
Last updated in NPPESAug 4, 2026
Details
- NPI
- 1104749290
- Entity type
- Organization (NPI-2)
- Legal business name
- Broughton Dunn PLLC
- Organization subpart
- No
- Enumeration date
- Aug 4, 2026
- Certification date
- Aug 4, 2026
- Last updated
- Aug 4, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
Practice location
8012 112th Street Ct E Ste 320Puyallup, WA 98373-7856
Phone 425-486-7764
Mailing address
8012 112th Street Ct E Ste 320Puyallup, WA 98373-7856
Authorized official
David Mai
Accountant
2538482331
Is something wrong?
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