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Dr. Guillermo Enrique Chacon, DDS
Oral and Maxillofacial Surgery (Dentist) in Puyallup, Washington
NPI 1619047511

Guillermo Enrique Chacon is a Oral and Maxillofacial Surgery (Dentist) based in Puyallup, WA and is specialized in Oral and Maxillofacial Surgery. Guillermo Enrique Chacon practices in Puyallup, WA and has the professional credentials of DDS. The NPI Number for Guillermo Enrique Chacon is 1619047511 and holds a License No. DE 60063175 (Washington).

The current practice location address for Guillermo Enrique Chacon is 2910 S Meridian, Puyallup, WA and can be reached out via phone at 253-445-0022 and via fax at 253-445-0979.

Location: 2910 S Meridian, Puyallup, WA, 98373-1585
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1619047511
Provider Name
Guillermo Enrique Chacon
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
2910 S Meridian, Puyallup, WA, 98373-1585
Phone Number
253-445-0022
Fax Number
253-445-0979
Provider Enumeration Date
11/08/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
2237985 05 WA
311203750028 01 OH CARESOURCE
2237985 01 OH BCMH
CH4046621 01 WA MEDICARE ID TYPE UNSPECIFIED PROVIDER
institution
Provider Business Practice Location Address Details
Address
2910 S Meridian
City
Puyallup
State
Washington
Zip
98373-1585
Phone Number
253-445-0022
Fax Number
253-445-0979
person
Provider Business Mailing Address Details
Address
2910 S Meridian
City
Puyallup
State
Washington
Zip
98373-1585
Phone Number
253-445-0022
Fax Number
253-445-0979
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Oral and Maxillofacial Surgery
Taxonomy
1223S0112X
License No.
DE 60063175 (Washington)
Definition
The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
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