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10830 19th Ave Se Suite A Everett WA 98208-5181 | |
| (425) 338-7134 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 10830 19th Ave Se, Everett, Washington |
| Authorized Official Name and Position | Andrew P Sholudko (DENTIST/OWNER) |
| Authorized Official Contact | 7742780412 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
10830 19th Ave Se Suite A Everett WA 98208-5181 Ph: (425) 338-7134 | 10830 19th Ave Se Suite A Everett WA 98208-5181 Ph: (425) 338-7134 |
| NPI Number | 1063806693 |
|---|---|
| Provider Enumeration Date | 03/20/2015 |
| Last Update Date | 03/20/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063806693 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DE60484387 (Washington) | Primary |
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