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Organization
BAKHTIAR ARDI PRIBADI DDS PS
Active
Organization
BAKHTIAR ARDI PRIBADI DDS PS
Active
Other names
Autumnwood Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BAKHTIAR ARDI PRIBADI DDS (OWNER)
(360) 474-9163
Entity
Organization
Contact information
Practice address
430 N WEST AVE STE 1, ARLINGTON, WA 98223-1539
(360) 474-9163
(360) 474-9180
Mailing address
430 N WEST AVE STE 1, ARLINGTON, WA 98223-1539
(360) 474-9163
(360) 474-9180
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DE00010465
WA
Other
Enumeration date
07/19/2010
Last updated
07/29/2010
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