Individual
KEVIN GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
111 SE EVERETT MALL WAY BLDG D, EVERETT, WA 98208-3208
(425) 667-3333
Mailing address
12483 PERSONS RD, BOW, WA 98232-7202
(360) 391-7455
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DENT.DE.61435584
WA
Other
Enumeration date
04/24/2023
Last updated
04/24/2023
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