| Ballard Pediatric Dentistry | |
|
530 Broadway East Apt #502 Seattle WA 98102 | |
| (206) 747-7661 | |
| Not Available |
| Full Name | Ballard Pediatric Dentistry |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 530 Broadway East, Seattle, Washington |
| Authorized Official Name and Position | Mamiko Kuriya (OWNER/ DENTIST) |
| Authorized Official Contact | 2067477661 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ballard Pediatric Dentistry 1400 Nw Market Street Suite 101 Seattle WA 98107 Ph: (206) 946-6970 | Ballard Pediatric Dentistry 530 Broadway East Apt #502 Seattle WA 98102 Ph: (206) 747-7661 |
| NPI Number | 1013463371 |
|---|---|
| Provider Enumeration Date | 08/28/2016 |
| Last Update Date | 08/28/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013463371 | NPI | - | NPPES |
| 2021256 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DE 10425 (Washington) | Primary |
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