# KIM & CERVANTES-KIM DDS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Elliott Bay Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730789082
- **Authorized official:** MISTY CERVANTES-KIM DDS (OWNER/DENTIST)
- **Authorized official phone:** (206) 812-7957

## Contact information

- **Practice address:** 945 ELLIOTT AVE W STE 212, SEATTLE, WA 98119-3645
- **Practice address phone:** (206) 812-7957
- **Practice address fax:** (206) 812-9506
- **Mailing address:** 945 ELLIOTT AVE W STE 212, SEATTLE, WA 98119-3645
- **Mailing address phone:** (206) 812-7957
- **Mailing address fax:** (206) 812-9506

## Taxonomy

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

## Other

- **Enumeration date:** 10/27/2020
- **Last updated:** 10/27/2020