| |
22516 Se 64th Pl Ste 200 Issaquah WA 98027-5503 | |
(425) 427-1120 | |
(425) 427-1125 |
Full Name | |
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Speciality | Clinic/center - Dental |
Location | 22516 Se 64th Pl Ste 200, Issaquah, Washington |
Authorized Official Name and Position | Willis P Gabel (OWNER) |
Authorized Official Contact | 4254271120 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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22516 Se 64th Pl Ste 200 Issaquah WA 98027-5503 Ph: (425) 427-1120 | 22516 Se 64th Pl Ste 200 Issaquah WA 98027-5503 Ph: (425) 427-1120 |
NPI Number | 1740633734 |
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Provider Enumeration Date | 07/14/2016 |
Last Update Date | 07/14/2016 |
Identifier | Type | State | Issuer |
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1740633734 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QD0000X | Clinic/center - Dental | DE00006359 (Washington) | Primary |
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