| Pike Place Dental | |
|
93 Pike St Suite 309 Seattle WA 98101-2052 | |
| (206) 625-1267 | |
| (206) 625-9017 |
| Full Name | Pike Place Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 93 Pike St, Seattle, Washington |
| Authorized Official Name and Position | Kent Sherman De Vigne (DENTIST /OWNER) |
| Authorized Official Contact | 2066251267 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pike Place Dental 93 Pike St Suite 309 Seattle WA 98101-2052 Ph: (206) 625-1267 | Pike Place Dental 93 Pike St Suite 309 Seattle WA 98101-2052 Ph: (206) 625-1267 |
| NPI Number | 1609321231 |
|---|---|
| Provider Enumeration Date | 08/24/2016 |
| Last Update Date | 08/24/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609321231 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 7034 (Washington) | Primary |
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