| Ballard Homeless Dental Clinic | |
|
1753 Nw 56th St Suite 200 Seattle WA 98107-5279 | |
| (206) 782-5939 | |
| (206) 782-5934 |
| Full Name | Ballard Homeless Dental Clinic |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1753 Nw 56th St, Seattle, Washington |
| Authorized Official Name and Position | Janine Childs (CFO) |
| Authorized Official Contact | 2065483034 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ballard Homeless Dental Clinic 1200 12th Ave S Suite 900 Seattle WA 98144-2712 Ph: (206) 548-3102 | Ballard Homeless Dental Clinic 1753 Nw 56th St Suite 200 Seattle WA 98107-5279 Ph: (206) 782-5939 |
| NPI Number | 1659739373 |
|---|---|
| Provider Enumeration Date | 02/09/2016 |
| Last Update Date | 02/09/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659739373 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Secondary |
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