Individual
MR. CHARLES FREDRICK EBSWORTH
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
17191 BOTHELL WAY NE, SUITE 201, LAKE FOREST PARK, WA 98155-5534
(206) 362-0152
(206) 365-3441
Mailing address
17191 BOTHELL WAY NE, SUITE 201, LAKE FOREST PARK, WA 98155-5534
(206) 362-0152
(206) 365-3441
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4073
WA
Other
Enumeration date
04/10/2006
Last updated
07/08/2007
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