| Dentiste | |
|
5726 Lake Washington Blvd Ne Ste S2 Kirkland WA 98033-7398 | |
| (425) 284-0515 | |
| (425) 284-0516 |
| Full Name | Dentiste |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 5726 Lake Washington Blvd Ne Ste S2, Kirkland, Washington |
| Authorized Official Name and Position | Michelle Rene Mayo (OFFICE MANAGER) |
| Authorized Official Contact | 4252840515 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dentiste 5726 Lake Washington Blvd Ne Ste S2 Kirkland WA 98033-7398 Ph: (425) 284-0515 | Dentiste 5726 Lake Washington Blvd Ne Ste S2 Kirkland WA 98033-7398 Ph: (425) 284-0515 |
| NPI Number | 1093823510 |
|---|---|
| Provider Enumeration Date | 08/25/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093823510 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 9147 (Washington) | Primary |
| 1223G0001X | Dentist - General Practice | 9147 (Washington) | Primary |
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