# RENTON SMILE DENTISTRY

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

## Provider details

- **NPI number:** 1982092805
- **Authorized official:** DR. ELIZABETH NIKOLAEVA MANCHESTER D.D.S. (DENTIST/OWNER)
- **Authorized official phone:** (206) 802-8414

## Contact information

- **Practice address:** 1107 SW GRADY WAY, SUITE 250, RENTON, WA 98057-5217
- **Practice address phone:** (425) 687-8860
- **Practice address fax:** (425) 687-8863
- **Mailing address:** 1107 SW GRADY WAY, SUITE 250, RENTON, WA 98057-5217
- **Mailing address phone:** (425) 687-8860
- **Mailing address fax:** (425) 687-8863

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | DE60475234 | WA | Yes |

## Other

- **Enumeration date:** 12/30/2014
- **Last updated:** 12/30/2014