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827 128th St Sw Suite B Everett WA 98204-5321 | |
| (425) 374-8218 | |
| (425) 374-8457 |
| Full Name | |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 827 128th St Sw, Everett, Washington |
| Authorized Official Name and Position | Peter M Pellegrini (PRESIDENT) |
| Authorized Official Contact | 4253748218 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
827 128th St Sw Suite B Everett WA 98204-5321 Ph: (425) 374-8218 | 827 128th St Sw Suite B Everett WA 98204-5321 Ph: (425) 374-8218 |
| NPI Number | 1245460088 |
|---|---|
| Provider Enumeration Date | 07/14/2009 |
| Last Update Date | 07/14/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245460088 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | DE600048914 (Washington) | Primary |
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