# EAGLE FAMILY DENTAL CENTER

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

## Provider details

- **NPI number:** 1801806898
- **Authorized official:** DR. JEFFREY D. HULEATT D.D.S. (DOCTOR/OWNER)
- **Authorized official phone:** (360) 435-2151

## Contact information

- **Practice address:** 20210 77TH AVE NE, ARLINGTON, WA 98223-4602
- **Practice address phone:** (360) 435-2151
- **Practice address fax:** (360) 435-7845
- **Mailing address:** 20210 77TH AVE NE, ARLINGTON, WA 98223-4602
- **Mailing address phone:** (360) 435-2151
- **Mailing address fax:** (360) 435-7845

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DE00006048 | WA | Yes |

## Other

- **Enumeration date:** 08/09/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | DE00006048 | STATE OF WASHINGTON LICEN | WV |
| 01 | — | DE00007379 | STATE OF WASH LICENSE | WA |