| Phd Covington Llc | |
|
615 Windsor Dr Se Sammamish WA 98074-3422 | |
| (253) 326-7777 | |
| Not Available |
| Full Name | Phd Covington Llc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 615 Windsor Dr Se, Sammamish, Washington |
| Authorized Official Name and Position | Shradha Bansal (OWNER) |
| Authorized Official Contact | 4258912461 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Phd Covington Llc 615 Windsor Dr Se Sammamish WA 98074-3422 Ph: () - | Phd Covington Llc 615 Windsor Dr Se Sammamish WA 98074-3422 Ph: (253) 326-7777 |
| NPI Number | 1275989196 |
|---|---|
| Provider Enumeration Date | 05/10/2016 |
| Last Update Date | 05/10/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275989196 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 8920 (Washington) | Primary |
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