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909 112th Ave Ne Suite P-104 Bellevue WA 98004-8580 | |
(425) 409-9999 | |
(888) 507-5181 |
Full Name | |
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Speciality | Dentist |
Location | 909 112th Ave Ne, Bellevue, Washington |
Authorized Official Name and Position | Beau J Keller (OWNER) |
Authorized Official Contact | 4257602704 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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909 112th Ave Ne Suite P-104 Bellevue WA 98004-8580 Ph: (425) 409-9999 | 909 112th Ave Ne Suite P-104 Bellevue WA 98004-8580 Ph: (425) 409-9999 |
NPI Number | 1619350857 |
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Provider Enumeration Date | 07/07/2015 |
Last Update Date | 07/07/2015 |
Identifier | Type | State | Issuer |
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1619350857 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | D009161 (Arizona) | Secondary |
122300000X | Dentist | DE00011082 (Washington) | Primary |
Dara Kim, Dds, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 4935 Lakemont Blvd Se Ste B3, Bellevue, WA 98006 Phone: 425-746-2101 | |
Navneet K Sekhon Dds Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 12917 Se 38th St Ste 206, Bellevue, WA 98006 Phone: 425-641-2960 | |
Marcus K. Flynn Dds Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 4301 Factoria Blvd Se Ste A, Bellevue, WA 98006 Phone: 425-641-8600 |