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1221 Madison St Ste 1116 Seattle WA 98104-3536 | |
| (206) 215-2088 | |
| (206) 215-2087 |
| Full Name | |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 1221 Madison St Ste 1116, Seattle, Washington |
| Authorized Official Name and Position | Gary R Feldman (PRESIDENT) |
| Authorized Official Contact | 2062152088 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1221 Madison St Ste 1116 Seattle WA 98104-3536 Ph: (206) 215-2088 | 1221 Madison St Ste 1116 Seattle WA 98104-3536 Ph: (206) 215-2088 |
| NPI Number | 1295257384 |
|---|---|
| Provider Enumeration Date | 07/11/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295257384 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 17630 (Washington) | Primary |
| 261Q00000X | Clinic/center | 17630 (Washington) | Secondary |
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