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4809 132nd St Se Ste A105 Everett WA 98208-6241 | |
(425) 585-0805 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Dental |
Location | 4809 132nd St Se Ste A105, Everett, Washington |
Authorized Official Name and Position | Kevin La (OWNER) |
Authorized Official Contact | 2134487706 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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17321 40th Ave Se Bothell WA 98012-5065 Ph: () - | 4809 132nd St Se Ste A105 Everett WA 98208-6241 Ph: (425) 585-0805 |
NPI Number | 1063922938 |
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Provider Enumeration Date | 10/05/2017 |
Last Update Date | 10/05/2017 |
Identifier | Type | State | Issuer |
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1063922938 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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