| Washingtonoralmaxillofacialsurgery | |
|
5929 Evergreen Way 300 Everett WA 98203-6031 | |
| (425) 356-3000 | |
| (452) 535-6316 |
| Full Name | Washingtonoralmaxillofacialsurgery |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 5929 Evergreen Way, Everett, Washington |
| Authorized Official Name and Position | Jae Y Hong (OWNER) |
| Authorized Official Contact | 4253563000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Washingtonoralmaxillofacialsurgery 5929 Evergreen Way 300 Everett WA 98203-6031 Ph: (425) 356-3000 | Washingtonoralmaxillofacialsurgery 5929 Evergreen Way 300 Everett WA 98203-6031 Ph: (425) 356-3000 |
| NPI Number | 1184944001 |
|---|---|
| Provider Enumeration Date | 06/02/2010 |
| Last Update Date | 06/02/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184944001 | NPI | - | NPPES |
| 5044888 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | DE8227 (Washington) | Primary |
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