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Organization
A STREET DENTAL CLINIC
Active
Organization
A STREET DENTAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN C LEUNG D.D.S. (PRACTICE OWNER/DENTIST)
(253) 288-9608
Entity
Organization
Contact information
Practice address
902 A ST SE, SUITE A, AUBURN, WA 98002-6056
(253) 288-9608
(253) 288-9631
Mailing address
702 SW 294TH ST, FEDERAL WAY, WA 98023-3542
(253) 288-9608
(253) 288-9631
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9810
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5040621
—
WA
Enumeration date
10/26/2006
Last updated
08/22/2020
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