| |
2150 112 Ave Ne #a Bellevue WA 98004 | |
(425) 455-0784 | |
(425) 451-3999 |
Full Name | |
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Speciality | Dentist - Pediatric Dentistry |
Location | 2150 112 Ave Ne #a, Bellevue, Washington |
Authorized Official Name and Position | La Nette A Mc Intosh (OFFICE MANAGER) |
Authorized Official Contact | 4254550784 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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2150 112 Ave Ne #a Bellevue WA 98004 Ph: (425) 455-0784 | 2150 112 Ave Ne #a Bellevue WA 98004 Ph: (425) 455-0784 |
NPI Number | 1497866255 |
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Provider Enumeration Date | 08/31/2006 |
Last Update Date | 11/17/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1497866255 | NPI | - | NPPES |
5018171 | Medicaid | WA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223P0221X | Dentist - Pediatric Dentistry | 4233 (Washington) | Primary |
Dara Kim, Dds, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 4935 Lakemont Blvd Se Ste B3, Bellevue, WA 98006 Phone: 425-746-2101 | |
Navneet K Sekhon Dds Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 12917 Se 38th St Ste 206, Bellevue, WA 98006 Phone: 425-641-2960 | |
Marcus K. Flynn Dds Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 4301 Factoria Blvd Se Ste A, Bellevue, WA 98006 Phone: 425-641-8600 |