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Organization
WASHINGTON DENTAL FEDERAL WAY, LLC
Active
Organization
WASHINGTON DENTAL FEDERAL WAY, LLC
Active
Other names
WA Dental
Organization subpart
No
Provider details
NPI number
Authorized official
YONG PARK (CEO)
(206) 592-2442
Entity
Organization
Contact information
Practice address
31515 PETE VON REICHBAUER WAY S UNIT 108, FEDERAL WAY, WA 98003-5599
(206) 592-2442
Mailing address
4040 ORCHARD ST W STE 200, FIRCREST, WA 98466-6615
(253) 393-2700
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/11/2019
Last updated
09/11/2019
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