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Organization
THEODORE M HENNESSEY DDS PS
Active
Organization
THEODORE M HENNESSEY DDS PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THEODORE M HENNESSEY DDS (OWNER)
(425) 774-7781
Entity
Organization
Contact information
Practice address
19715 SCRIBER LAKE RD STE C, LYNNWOOD, WA 98036-6165
(425) 774-7781
Mailing address
19715 SCRIBER LAKE RD STE C, LYNNWOOD, WA 98036-6165
(425) 774-7781
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE00010589
WA
Other
Enumeration date
06/17/2012
Last updated
06/17/2012
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