| Eric Der Ovanessian Dds Ps Inc | |
|
15710 Ne 24th Street #b Bellevue WA 98008 | |
| (425) 643-7100 | |
| (425) 644-1426 |
| Full Name | Eric Der Ovanessian Dds Ps Inc |
|---|---|
| Speciality | Dentist |
| Location | 15710 Ne 24th Street, Bellevue, Washington |
| Authorized Official Name and Position | Eric Der Ovanessian (PRESIDENT) |
| Authorized Official Contact | 4256437100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eric Der Ovanessian Dds Ps Inc 15710 Ne 24th Street #b Bellevue WA 98008 Ph: (425) 643-7100 | Eric Der Ovanessian Dds Ps Inc 15710 Ne 24th Street #b Bellevue WA 98008 Ph: (425) 643-7100 |
| NPI Number | 1194898379 |
|---|---|
| Provider Enumeration Date | 11/16/2006 |
| Last Update Date | 08/06/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194898379 | NPI | - | NPPES |
| 5034913 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 7600 (Washington) | Primary |
| 122300000X | Dentist | 39144 (California) | Secondary |
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