| Bellevue Kids Dentist | |
|
2150 112 Ave Ne #a Bellevue WA 98004 | |
| (425) 455-0784 | |
| (425) 451-3999 |
| Full Name | Bellevue Kids Dentist |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 2150 112 Ave Ne #a, Bellevue, Washington |
| Authorized Official Name and Position | La Nette A Mc Intosh (OFFICE MANAGER) |
| Authorized Official Contact | 4254550784 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bellevue Kids Dentist 2150 112 Ave Ne #a Bellevue WA 98004 Ph: (425) 455-0784 | Bellevue Kids Dentist 2150 112 Ave Ne #a Bellevue WA 98004 Ph: (425) 455-0784 |
| NPI Number | 1497866255 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 11/17/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497866255 | NPI | - | NPPES |
| 5018171 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 4233 (Washington) | Primary |
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