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8575 164th Ave Ne Ste 200 Redmond WA 98052-3679 | |
(217) 540-5100 | |
Not Available |
Full Name | |
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Speciality | Dentist - General Practice |
Location | 8575 164th Ave Ne Ste 200, Redmond, Washington |
Authorized Official Name and Position | Jessica Britt (CREDENTIALING COORDINATOR) |
Authorized Official Contact | 2175405100 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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8575 164th Ave Ne Ste 200 Redmond WA 98052-3679 Ph: () - | 8575 164th Ave Ne Ste 200 Redmond WA 98052-3679 Ph: (217) 540-5100 |
NPI Number | 1942787569 |
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Provider Enumeration Date | 07/26/2018 |
Last Update Date | 09/22/2020 |
Identifier | Type | State | Issuer |
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1942787569 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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