# COSMETIC & FAMILY DENTISTRY OF MILL CREEK

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

## Provider details

- **NPI number:** 1366696114
- **Authorized official:** MS. NANETTE F MEADE OFFICE MANAGER (OFFICE MANAGER)
- **Authorized official phone:** (425) 742-3606

## Contact information

- **Practice address:** 16504 9TH AVE SE STE 103, MILL CREEK, WA 98012-6388
- **Practice address phone:** (425) 742-3606
- **Practice address fax:** (425) 743-4476
- **Mailing address:** 16504 9TH AVE SE STE 103, MILL CREEK, WA 98012-6388
- **Mailing address phone:** (425) 742-3606
- **Mailing address fax:** (425) 743-4476

## Taxonomy

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

## Other

- **Enumeration date:** 11/06/2008
- **Last updated:** 11/06/2008