# NORTHSHORE DENTAL CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Northshore Dental Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760695282
- **Authorized official:** DIANE VO DDS (OWNER)
- **Authorized official phone:** (425) 785-8305

## Contact information

- **Practice address:** 18404 104TH AVE NE, BOTHELL, WA 98011-3414
- **Practice address phone:** (425) 486-2422
- **Practice address fax:** (425) 486-2712
- **Mailing address:** 18404 104TH AVE NE, BOTHELL, WA 98011-3414
- **Mailing address phone:** (425) 241-2960
- **Mailing address fax:** (425) 486-2712

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | DE00007951 | WA | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |

## Other

- **Enumeration date:** 05/08/2007
- **Last updated:** 01/12/2023