| Leo S. Henrichsen,d.d.s., P.s | |
|
5723 Ne Bothell Way Ste D Kenmore WA 98028-9404 | |
| (206) 364-7181 | |
| (425) 483-6056 |
| Full Name | Leo S. Henrichsen,d.d.s., P.s |
|---|---|
| Speciality | Dentist |
| Location | 5723 Ne Bothell Way Ste D, Kenmore, Washington |
| Authorized Official Name and Position | Leo S Henrichsen (PRESIDENT) |
| Authorized Official Contact | 2063647181 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Leo S. Henrichsen,d.d.s., P.s 5723 Ne Bothell Way Ste D Kenmore WA 98028-9404 Ph: (206) 364-7181 | Leo S. Henrichsen,d.d.s., P.s 5723 Ne Bothell Way Ste D Kenmore WA 98028-9404 Ph: (206) 364-7181 |
| NPI Number | 1972713972 |
|---|---|
| Provider Enumeration Date | 05/22/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972713972 | NPI | - | NPPES |
| 5113105 | Medicaid | WA | |
| 01131 | Other | WA | WASHINGTON DENTAL SERVICE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 3280 (Washington) | Primary |
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