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22506 Marine View Dr S Suite 101 Des Moines WA 98198-6906 | |
| (206) 249-8880 | |
| (206) 592-2386 |
| Full Name | |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 22506 Marine View Dr S, Des Moines, Washington |
| Authorized Official Name and Position | Smita Patel (OWNER/ORTHODONTIST) |
| Authorized Official Contact | 2062498880 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
22506 Marine View Dr S Suite 101 Des Moines WA 98198-6906 Ph: (206) 249-8880 | 22506 Marine View Dr S Suite 101 Des Moines WA 98198-6906 Ph: (206) 249-8880 |
| NPI Number | 1982057998 |
|---|---|
| Provider Enumeration Date | 07/14/2016 |
| Last Update Date | 03/22/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982057998 | NPI | - | NPPES |
| 1467668608 | Other | WA | TYPE 1 NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | DE10731 (Washington) | Primary |
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