| |
5723 Ne Bothell Way Ste B Kenmore WA 98028-9404 | |
(425) 485-0588 | |
(425) 483-6189 |
Full Name | |
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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 |
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5723 Ne Bothell Way Ste B Kenmore WA 98028-9404 Ph: (425) 485-0588 | 5723 Ne Bothell Way Ste B Kenmore WA 98028-9404 Ph: (425) 485-0588 |
NPI Number | 1366748105 |
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Provider Enumeration Date | 01/26/2011 |
Last Update Date | 07/21/2016 |
Identifier | Type | State | Issuer |
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1366748105 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223G0001X | Dentist - General Practice | 7496 (Washington) | Primary |
Dental Assistant Training Center Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 5701 Ne Bothell Way Ste 2, Kenmore, WA 98028 Phone: 425-806-8816 Fax: 425-806-8832 | |
Northshore Endodontics Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 5701 Ne Bothell Way, Suite 1, Kenmore, WA 98028 Phone: 425-488-9785 Fax: 425-402-0835 | |
Carol Lin Dds, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 5701 Ne Bothell Way Ste 5, Kenmore, WA 98028 Phone: 425-488-1405 | |