| Prodental Family Dentistry | |
|
3005 Alderwood Mall Pkwy Ste 200 Lynnwood WA 98036-6920 | |
| (425) 673-8919 | |
| (425) 673-5674 |
| Full Name | Prodental Family Dentistry |
|---|---|
| Speciality | Dentist |
| Location | 3005 Alderwood Mall Pkwy, Lynnwood, Washington |
| Authorized Official Name and Position | Valeriy Beliy (MEMBER) |
| Authorized Official Contact | 4256738919 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prodental Family Dentistry 3005 Alderwood Mall Pkwy Ste 200 Lynnwood WA 98036-6920 Ph: (425) 673-8919 | Prodental Family Dentistry 3005 Alderwood Mall Pkwy Ste 200 Lynnwood WA 98036-6920 Ph: (425) 673-8919 |
| NPI Number | 1649589813 |
|---|---|
| Provider Enumeration Date | 10/05/2010 |
| Last Update Date | 10/05/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649589813 | NPI | - | NPPES |
| 5033741 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DE 00008313 (Washington) | Primary |
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