| Edmonds Bay Dental | |
|
51 W Dayton Suite 301 Edmonds WA 98020 | |
| (425) 775-5162 | |
| (425) 491-8100 |
| Full Name | Edmonds Bay Dental |
|---|---|
| Speciality | Dentist |
| Location | 51 W Dayton, Edmonds, Washington |
| Authorized Official Name and Position | James V Mischel (OWNER) |
| Authorized Official Contact | 4257755162 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Edmonds Bay Dental 51 W Dayton Suite 301 Edmonds WA 98020 Ph: (425) 775-5162 | Edmonds Bay Dental 51 W Dayton Suite 301 Edmonds WA 98020 Ph: (425) 775-5162 |
| NPI Number | 1942279997 |
|---|---|
| Provider Enumeration Date | 03/14/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942279997 | NPI | - | NPPES |
| 5049457 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DE00005091 (Washington) | Primary |
| 122300000X | Dentist | DE0010360 (Washington) | Secondary |
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