| Mercer Island Orthodontics | |
|
14300 Se Petrovitsky Road Renton WA 98058 | |
| (425) 235-8800 | |
| (425) 235-0288 |
| Full Name | Mercer Island Orthodontics |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 14300 Se Petrovitsky Road, Renton, Washington |
| Authorized Official Name and Position | Mario D Chorak (ORTHODONTIST OWNER) |
| Authorized Official Contact | 4252358800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mercer Island Orthodontics 14300 Se Petrovitsky Road Renton WA 98058 Ph: (425) 235-8800 | Mercer Island Orthodontics 14300 Se Petrovitsky Road Renton WA 98058 Ph: (425) 235-8800 |
| NPI Number | 1619037157 |
|---|---|
| Provider Enumeration Date | 12/12/2006 |
| Last Update Date | 08/08/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619037157 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | DE00008957 (Washington) | Primary |
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