| Northshore Dental Center | |
|
18404 104th Ave Ne Bothell WA 98011-3414 | |
| (425) 486-2422 | |
| (425) 486-2712 |
| Full Name | Northshore Dental Center |
|---|---|
| Speciality | Dentist |
| Location | 18404 104th Ave Ne, Bothell, Washington |
| Authorized Official Name and Position | Diane Vo (OWNER) |
| Authorized Official Contact | 4257858305 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northshore Dental Center 18404 104th Ave Ne Bothell WA 98011-3414 Ph: (425) 241-2960 | Northshore Dental Center 18404 104th Ave Ne Bothell WA 98011-3414 Ph: (425) 486-2422 |
| NPI Number | 1760695282 |
|---|---|
| Provider Enumeration Date | 05/08/2007 |
| Last Update Date | 01/12/2023 |
| Medicare PECOS PAC ID | 7214383223 |
|---|---|
| Medicare Enrollment ID | O20231027000758 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760695282 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DE00007951 (Washington) | Primary |
| 332B00000X | Durable Medical Equipment & Medical Supplies | (* (Not Available)) | Secondary |
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