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4540 Sandpoint Way Ne Suite 140 Seattle WA 98105 | |
| (206) 525-7000 | |
| (206) 525-0479 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 4540 Sandpoint Way Ne, Seattle, Washington |
| Authorized Official Name and Position | Anthony T. Lovrovich (PRESIDENT) |
| Authorized Official Contact | 2065257000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
4540 Sandpoint Way Ne Suite 140 Seattle WA 98105 Ph: (206) 525-7000 | 4540 Sandpoint Way Ne Suite 140 Seattle WA 98105 Ph: (206) 525-7000 |
| NPI Number | 1801031653 |
|---|---|
| Provider Enumeration Date | 12/09/2008 |
| Last Update Date | 12/09/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801031653 | NPI | - | NPPES |
| 5019450 | Medicaid | WA | |
| 7980 | Other | WA | DEPT. OF HEALTH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 5590 (Washington) | Primary |
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