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8730 Rainier Ave S Seattle WA 98118-4927 | |
| (206) 721-8730 | |
| (206) 721-5947 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 8730 Rainier Ave S, Seattle, Washington |
| Authorized Official Name and Position | Dat Khoa Nguyen (MEMBER, MANAGER) |
| Authorized Official Contact | 2067218730 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
8730 Rainier Ave S Seattle WA 98118-4927 Ph: (206) 721-8730 | 8730 Rainier Ave S Seattle WA 98118-4927 Ph: (206) 721-8730 |
| NPI Number | 1043503071 |
|---|---|
| Provider Enumeration Date | 05/24/2011 |
| Last Update Date | 05/24/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043503071 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DE10287 (Washington) | Primary |
| 1223G0001X | Dentist - General Practice | DE10306 (Washington) | Secondary |
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