# DAYA BHAT DDS MS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Michael Wagner DDS
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003452202
- **Authorized official:** DAYA BHAT DDS, MS (DENTIST/OWNER)
- **Authorized official phone:** (312) 315-7604

## Contact information

- **Practice address:** 13515 NE 175TH ST STE G, WOODINVILLE, WA 98072-8566
- **Practice address phone:** (312) 315-7604
- **Mailing address:** 13515 NE 175TH ST STE G, WOODINVILLE, WA 98072-8566

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 11/22/2019
- **Last updated:** 11/22/2019