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1519 132nd St Se Ste G Everett WA 98208-7203 | |
(425) 616-3729 | |
(425) 616-3751 |
Full Name | |
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Speciality | Dentist |
Location | 1519 132nd St Se Ste G, Everett, Washington |
Authorized Official Name and Position | Dulce Gomez (CREDENTIALING COORDINATOR) |
Authorized Official Contact | 7148458701 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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17000 Red Hill Ave Irvine CA 92614-5626 Ph: (714) 845-8500 | 1519 132nd St Se Ste G Everett WA 98208-7203 Ph: (425) 616-3729 |
NPI Number | 1750885471 |
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Provider Enumeration Date | 03/19/2018 |
Last Update Date | 03/19/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1750885471 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | (* (Not Available)) | Primary |
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