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1706 S 320th St Ste E Federal Way WA 98003-5424 | |
(206) 552-1952 | |
Not Available |
Full Name | |
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Speciality | Dentist |
Location | 1706 S 320th St Ste E, Federal Way, Washington |
Authorized Official Name and Position | Amanda Jie Huang (OWNER) |
Authorized Official Contact | 2065521952 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1706 S 320th St Ste E Federal Way WA 98003-5424 Ph: (206) 552-1952 | 1706 S 320th St Ste E Federal Way WA 98003-5424 Ph: (206) 552-1952 |
NPI Number | 1922441385 |
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Provider Enumeration Date | 04/16/2013 |
Last Update Date | 03/10/2022 |
Medicare PECOS PAC ID | 1759776636 |
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Medicare Enrollment ID | O20220310001855 |
Identifier | Type | State | Issuer |
---|---|---|---|
1922441385 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223G0001X | Dentist - General Practice | DE 60262499 (Washington) | Primary |
Provider Name | Amanda Jie Huang |
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Provider Type | Practitioner - Oral Surgery |
Provider Identifiers | NPI Number: 1174551972 PECOS PAC ID: 2668867540 Enrollment ID: I20220314002057 |
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