# THE MILL CREEK DENTIST

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

## Provider details

- **NPI number:** 1205209913
- **Authorized official:** DR. KIM A WALTER DDS (OWNER)
- **Authorized official phone:** (425) 745-4661

## Contact information

- **Practice address:** 16306 BOTHELL EVERETT HWY, SUITE B, MILL CREEK, WA 98012-1283
- **Practice address phone:** (425) 745-4661
- **Practice address fax:** (425) 491-7077
- **Mailing address:** 16306 BOTHELL EVERETT HWY, SUITE B, MILL CREEK, WA 98012-1283
- **Mailing address phone:** (425) 745-4661
- **Mailing address fax:** (425) 491-7077

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DE00005339 | WA | Yes |

## Other

- **Enumeration date:** 11/03/2015
- **Last updated:** 11/03/2015