# CLOVERDALE FAMILY DENTISTRY

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

## Provider details

- **NPI number:** 1831534155
- **Authorized official:** TINA FUJII D.D.S. (OWNER)
- **Authorized official phone:** (206) 762-2337

## Contact information

- **Practice address:** 1415 S CLOVERDALE ST, SEATTLE, WA 98108-4826
- **Practice address phone:** (206) 762-2337
- **Practice address fax:** (206) 762-0344
- **Mailing address:** 1415 S CLOVERDALE ST, SEATTLE, WA 98108-4826
- **Mailing address phone:** (206) 762-2337
- **Mailing address fax:** (206) 762-0344

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DE00008520 | WA | Yes |

## Other

- **Enumeration date:** 04/30/2013
- **Last updated:** 04/30/2013