# MOBILE DENT INC PS

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

## Provider details

- **NPI number:** 1811026628
- **Authorized official:** DR. PETER E MOORE DDS (DENTIST PRESIDENT)
- **Authorized official phone:** (425) 747-5424

## Contact information

- **Practice address:** 13300 SE 30TH ST SUITE 101, BELLEVUE, WA 98005
- **Practice address phone:** (425) 747-5424
- **Practice address fax:** (425) 746-6332
- **Mailing address:** 13300 SE 30TH ST SUITE 101, BELLEVUE, WA 98005
- **Mailing address phone:** (425) 747-5424
- **Mailing address fax:** (425) 746-6332

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 5092 | WA | Yes |

## Other

- **Enumeration date:** 03/05/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 5531108 | — | WA |