| Minh Dau, Dds And Raymond Park, Dds Pllc | |
|
3105 Alderwood Mall Blvd Suite 117 Lynnwood WA 98036-4703 | |
| (425) 284-9886 | |
| Not Available |
| Full Name | Minh Dau, Dds And Raymond Park, Dds Pllc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 3105 Alderwood Mall Blvd, Lynnwood, Washington |
| Authorized Official Name and Position | Raymond Park (GOVERNOR) |
| Authorized Official Contact | 4252849886 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Minh Dau, Dds And Raymond Park, Dds Pllc 3105 Alderwood Mall Blvd Suite 117 Lynnwood WA 98036-4703 Ph: (425) 284-9886 | Minh Dau, Dds And Raymond Park, Dds Pllc 3105 Alderwood Mall Blvd Suite 117 Lynnwood WA 98036-4703 Ph: (425) 284-9886 |
| NPI Number | 1831624402 |
|---|---|
| Provider Enumeration Date | 04/20/2017 |
| Last Update Date | 04/20/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831624402 | NPI | - | NPPES |
| 1861743205 | Medicaid | WA | |
| 1548521248 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | DE60467195 (Washington) | Primary |
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