| Dentist | |
|
16108 Ash Way Ste 202 Lynnwood WA 98087-8781 | |
| (425) 741-2030 | |
| (425) 741-2026 |
| Full Name | Dentist |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 16108 Ash Way Ste 202, Lynnwood, Washington |
| Authorized Official Name and Position | Irina Zayats (MANAGER) |
| Authorized Official Contact | 4257412030 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dentist 16108 Ash Way Ste 202 Lynnwood WA 98087-8781 Ph: (425) 741-2030 | Dentist 16108 Ash Way Ste 202 Lynnwood WA 98087-8781 Ph: (425) 741-2030 |
| NPI Number | 1215447677 |
|---|---|
| Provider Enumeration Date | 10/11/2017 |
| Last Update Date | 06/16/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215447677 | NPI | - | NPPES |
| 1001094 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DE00010297 (Washington) | Primary |
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