| Eastside Kids Dentistry | |
|
8630 164th Ave Ne Ste 202 Redmond WA 98052-3606 | |
| (425) 968-2840 | |
| Not Available |
| Full Name | Eastside Kids Dentistry |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 8630 164th Ave Ne, Redmond, Washington |
| Authorized Official Name and Position | Michael Lee (CONTACT) |
| Authorized Official Contact | 4259682840 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eastside Kids Dentistry 8630 164th Ave Ne Suite 202 Redmond WA 98052-3606 Ph: (425) 968-2840 | Eastside Kids Dentistry 8630 164th Ave Ne Ste 202 Redmond WA 98052-3606 Ph: (425) 968-2840 |
| NPI Number | 1780009407 |
|---|---|
| Provider Enumeration Date | 03/04/2014 |
| Last Update Date | 11/09/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780009407 | NPI | - | NPPES |
| 2024262 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DE6021630 (Washington) | Primary |
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