| Ivy Dental For Kids | |
|
18623 Hwy 99 Suite 210 Lynnwood WA 98037-4552 | |
| (425) 275-9977 | |
| (425) 275-9979 |
| Full Name | Ivy Dental For Kids |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 18623 Hwy 99, Lynnwood, Washington |
| Authorized Official Name and Position | Yoon Lee (DENTIST) |
| Authorized Official Contact | 4252759977 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ivy Dental For Kids 18623 Hwy 99 Suite 210 Lynnwood WA 98037-4552 Ph: (425) 275-9977 | Ivy Dental For Kids 18623 Hwy 99 Suite 210 Lynnwood WA 98037-4552 Ph: (425) 275-9977 |
| NPI Number | 1639381874 |
|---|---|
| Provider Enumeration Date | 05/03/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639381874 | NPI | - | NPPES |
| 5041611 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 9491 (Washington) | Primary |
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