# MONA BUTANI DMD PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Totem Lake Family Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508423682
- **Authorized official:** MICHELLE CLARK (OFFICE MANAGER)
- **Authorized official phone:** (425) 820-0900

## Contact information

- **Practice address:** 12911 120TH AVE NE STE D50, KIRKLAND, WA 98034-3007
- **Practice address phone:** (425) 820-0900
- **Mailing address:** 12911 120TH AVE NE STE D50, KIRKLAND, WA 98034-3007
- **Mailing address phone:** (425) 820-0900

## Taxonomy

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

## Other

- **Enumeration date:** 05/23/2019
- **Last updated:** 06/11/2019