| Lynnwood Prime Dental Group | |
|
3333 184th St Sw Suite #u Lynnwood WA 98037-4724 | |
| (425) 251-0707 | |
| Not Available |
| Full Name | Lynnwood Prime Dental Group |
|---|---|
| Speciality | Dentist |
| Location | 3333 184th St Sw, Lynnwood, Washington |
| Authorized Official Name and Position | Yongjae Kim (MEMBER) |
| Authorized Official Contact | 4254573638 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lynnwood Prime Dental Group Po Box 4086 Bellevue WA 98009-4086 Ph: () - | Lynnwood Prime Dental Group 3333 184th St Sw Suite #u Lynnwood WA 98037-4724 Ph: (425) 251-0707 |
| NPI Number | 1558598268 |
|---|---|
| Provider Enumeration Date | 06/20/2009 |
| Last Update Date | 12/10/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558598268 | NPI | - | NPPES |
| 5060132 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DE00011116 (Washington) | Primary |
| 122300000X | Dentist | DE00011115 (Washington) | Secondary |
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