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Organization
CRISAFULLI DENTAL
Active
Organization
CRISAFULLI DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WENDY CRISAFULLI (OWNER/DENTIST)
(425) 483-5838
Entity
Organization
Contact information
Practice address
18920 BOTHELL WAY NE STE 200, BOTHELL, WA 98011-1981
(425) 483-5838
Mailing address
18920 BOTHELL WAY NE STE 200, BOTHELL, WA 98011-1981
(425) 483-5838
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
NULL
122300000X
Dentist
—
—
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0300X
Periodontics
—
NULL
1223P0300X
Periodontics
—
—
1223P0700X
Prosthodontics
—
NULL
1223P0700X
Prosthodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
NULL
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
09/09/2020
Last updated
09/28/2020
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