| Kenmore Dental | |
|
5723 Ne Bothell Way Ste B Kenmore WA 98028-9404 | |
| (425) 485-0588 | |
| (425) 483-6189 |
| Full Name | Kenmore Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 5723 Ne Bothell Way Ste B, Kenmore, Washington |
| Authorized Official Name and Position | Teri Anne Shackelford (OFFICE MANGER) |
| Authorized Official Contact | 4254850588 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kenmore Dental 5723 Ne Bothell Way Ste B Kenmore WA 98028-9404 Ph: (425) 485-0588 | Kenmore Dental 5723 Ne Bothell Way Ste B Kenmore WA 98028-9404 Ph: (425) 485-0588 |
| NPI Number | 1366748105 |
|---|---|
| Provider Enumeration Date | 01/26/2011 |
| Last Update Date | 07/21/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366748105 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 7496 (Washington) | Primary |
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