# TOMMY FONG, DDS, VIVIAN M. BENNETT, DDS, PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Highlands West Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871628446
- **Authorized official:** DR. VIVIAN MARIE BENNETT DDS (VP)
- **Authorized official phone:** (206) 542-7000

## Contact information

- **Practice address:** 735 N 185TH ST, SHORELINE, WA 98133-3901
- **Practice address phone:** (206) 542-7000
- **Mailing address:** 735 N 185TH ST, SHORELINE, WA 98133-3901
- **Mailing address phone:** (206) 542-7000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DE00006035 | WA | Yes |

## Other

- **Enumeration date:** 02/22/2007
- **Last updated:** 08/22/2020