|
| |
|
4219 S Othello St Ste 105d Seattle WA 98118-3873 | |
| (206) 316-2351 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 4219 S Othello St Ste 105d, Seattle, Washington |
| Authorized Official Name and Position | Yonatan Nir Ahdut (DENTIST/OWNER) |
| Authorized Official Contact | 2534265821 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
4219 S Othello St Ste 105d Seattle WA 98118-3873 Ph: (206) 316-2351 | 4219 S Othello St Ste 105d Seattle WA 98118-3873 Ph: (206) 316-2351 |
| NPI Number | 1881189322 |
|---|---|
| Provider Enumeration Date | 06/27/2018 |
| Last Update Date | 06/11/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881189322 | NPI | - | NPPES |
| 2036949 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DE60479557 (Washington) | Primary |
Gile, Nov, Fernyough Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 900 Lenora St, Suite 216, Seattle, WA 98121 Phone: 206-402-5490 | |
Tverskoy Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 4000 Sw Admiral Way, Seattle, WA 98116 Phone: 206-935-2632 | |
Guerrero & Song Dds Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 W. Harrison Street, Suite #150, North Tower, Seattle, WA 98119 Phone: 206-284-4412 | |
Wally W Kegel Dds Msd Ps Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 509 Olive Way, Suite 627, Seattle, WA 98101 Phone: 206-682-9269 Fax: 206-624-4140 | |