# CRYSTAL DENTAL INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184047466
- **Authorized official:** DR. CHRIS JOON LEE DMD (DENTIST)
- **Authorized official phone:** (425) 282-4182

## Contact information

- **Practice address:** 12644 164TH AVE SE, RENTON, WA 98059-6403
- **Practice address phone:** (425) 282-4182
- **Practice address fax:** (425) 572-6072
- **Mailing address:** 12644 164TH AVE SE, RENTON, WA 98059-6403
- **Mailing address phone:** (425) 282-4182
- **Mailing address fax:** (425) 572-6072

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DE60389882 | WA | Yes |

## Other

- **Enumeration date:** 01/23/2014
- **Last updated:** 01/23/2014