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Organization
SUPERTOOTH DENTISTRY
Active
Organization
SUPERTOOTH DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL KITSIS (PRESIDENT)
(206) 953-8544
Entity
Organization
Contact information
Practice address
133 QUEEN ANNE AVE N, SEATTLE, WA 98109-4980
(206) 953-8544
Mailing address
133 QUEEN ANNE AVE N, SEATTLE, WA 98109-4980
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
NULL
122300000X
Dentist
Primary
—
—
Other
Enumeration date
06/29/2011
Last updated
06/29/2011
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