# DA VINCI DENTAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** DA VINCI DENTAL LLC
- **Other names:** KALM Dental Spa
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1619350857
- **Legal business name:** DA VINCI DENTAL LLC
- **Authorized official:** DR. BEAU J KELLER DDS (OWNER)
- **Authorized official phone:** (425) 760-2704

## Contact information

- **Practice address:** 909 112TH AVE NE, SUITE P-104, BELLEVUE, WA 98004-8580
- **Practice address phone:** (425) 409-9999
- **Practice address fax:** (888) 507-5181
- **Mailing address:** 909 112TH AVE NE, SUITE P-104, BELLEVUE, WA 98004-8580
- **Mailing address phone:** (425) 409-9999
- **Mailing address fax:** (888) 507-5181

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | D009161 | AZ | — |
| 122300000X | Dentist | DE00011082 | WA | Yes |

## Other

- **Enumeration date:** 07/07/2015
- **Last updated:** 07/07/2015