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5710 Bothell Way Ne Ste. 5 Kenmore WA 98028 | |
(425) 488-1405 | |
Not Available |
Full Name | |
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Speciality | Dentist - General Practice |
Location | 5710 Bothell Way Ne, Kenmore, Washington |
Authorized Official Name and Position | Benjamin Dorantes (OWNER) |
Authorized Official Contact | 2063803885 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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5710 Bothell Way Ne Ste. 5 Kenmore WA 98028 Ph: (425) 488-1405 | 5710 Bothell Way Ne Ste. 5 Kenmore WA 98028 Ph: (425) 488-1405 |
NPI Number | 1760732580 |
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Provider Enumeration Date | 09/19/2012 |
Last Update Date | 09/19/2012 |
Identifier | Type | State | Issuer |
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1760732580 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223G0001X | Dentist - General Practice | 1223G0001X (Washington) | Primary |
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