# GREEN LAKE FACIAL SURGERY PLLC

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

## Provider details

- **NPI number:** 1730506064
- **Authorized official:** DR. MATTHEW SHANE EPSTEIN DDS (OWNER)
- **Authorized official phone:** (120) 696-3906

## Contact information

- **Practice address:** 7900 E GREEN LAKE DR N, SUITE 302, SEATTLE, WA 98103-4800
- **Practice address phone:** (206) 693-3906
- **Mailing address:** 7900 E GREEN LAKE DR N, SUITE 302, SEATTLE, WA 98103-4800
- **Mailing address phone:** (206) 693-3906

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | DE 60277222 | WA | Yes |

## Other

- **Enumeration date:** 03/25/2014
- **Last updated:** 03/25/2014