| Seattle Jaw Surgery | |
|
600 Broadway Ste 460 Seattle WA 98122-5312 | |
| (206) 320-2078 | |
| Not Available |
| Full Name | Seattle Jaw Surgery |
|---|---|
| Speciality | Clinic/Center |
| Location | 600 Broadway Ste 460, Seattle, Washington |
| Authorized Official Name and Position | Samuel Bobek (OWNER) |
| Authorized Official Contact | 5034754735 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Seattle Jaw Surgery 600 Broadway Ste 460 Seattle WA 98122-5312 Ph: (206) 320-2078 | Seattle Jaw Surgery 600 Broadway Ste 460 Seattle WA 98122-5312 Ph: (206) 320-2078 |
| NPI Number | 1841833431 |
|---|---|
| Provider Enumeration Date | 10/25/2019 |
| Last Update Date | 10/28/2019 |
| Medicare PECOS PAC ID | 2769810209 |
|---|---|
| Medicare Enrollment ID | O20200317001540 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841833431 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (NU) | Primary |
| 363AS0400X | Physician Assistant - Surgical | (NU) | Secondary |
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (NU) | Secondary |
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