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Organization
LEO S. HENRICHSEN,D.D.S., P.S
Active
Organization
LEO S. HENRICHSEN,D.D.S., P.S
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEO S HENRICHSEN DDS,PS (PRESIDENT)
(206) 364-7181
Entity
Organization
Contact information
Practice address
5723 NE BOTHELL WAY STE D, KENMORE, WA 98028-9404
(206) 364-7181
(425) 483-6056
Mailing address
5723 NE BOTHELL WAY STE D, KENMORE, WA 98028-9404
(206) 364-7181
(425) 483-6056
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3280
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01131
WASHINGTON DENTAL SERVICE
WA
05
—
5113105
—
WA
Enumeration date
05/22/2007
Last updated
08/22/2020
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