# SOUTH RAINIER DENTISTRY, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** south rainier dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043503071
- **Authorized official:** DR. DAT KHOA NGUYEN DDS (MEMBER, MANAGER)
- **Authorized official phone:** (206) 721-8730

## Contact information

- **Practice address:** 8730 RAINIER AVE S, SEATTLE, WA 98118-4927
- **Practice address phone:** (206) 721-8730
- **Practice address fax:** (206) 721-5947
- **Mailing address:** 8730 RAINIER AVE S, SEATTLE, WA 98118-4927
- **Mailing address phone:** (206) 721-8730
- **Mailing address fax:** (206) 721-5947

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DE10287 | WA | Yes |
| 1223G0001X | General Practice Dentistry | DE10306 | WA | — |

## Other

- **Enumeration date:** 05/24/2011
- **Last updated:** 05/24/2011