| Crescent Dental Bonney Lake | |
|
10004 204th Ave E Ste 2500 Bonney Lake WA 98391-6539 | |
| (253) 447-8344 | |
| (253) 447-8580 |
| Full Name | Crescent Dental Bonney Lake |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 10004 204th Ave E Ste 2500, Bonney Lake, Washington |
| Authorized Official Name and Position | Syed Rehan Bashar (OWNER/SOLE PROPRIETOR) |
| Authorized Official Contact | 9095563146 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Crescent Dental Bonney Lake 10004 204th Ave E Ste 2500 Bonney Lake WA 98391-6539 Ph: (253) 447-8344 | Crescent Dental Bonney Lake 10004 204th Ave E Ste 2500 Bonney Lake WA 98391-6539 Ph: (253) 447-8344 |
| NPI Number | 1801554084 |
|---|---|
| Provider Enumeration Date | 12/03/2021 |
| Last Update Date | 12/25/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801554084 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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