Individual
BRYAN IKSU SHIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
927 128TH ST SW, EVERETT, WA 98204-6315
(425) 290-6967
Mailing address
12721 192ND PL E, BONNEY LAKE, WA 98391-8362
(614) 364-1695
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
30.025406
OH
1223G0001X
General Practice Dentistry
Primary
DE61103820
WA
Other
Enumeration date
09/20/2018
Last updated
06/22/2022
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