Individual
THERON ANGUS MANSON I
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
9750 NE 120TH PL #8, KIRKLAND, WA 98034-4207
(425) 823-1909
(425) 823-8969
Mailing address
9750 NE 120TH PL #8, KIRKLAND, WA 98034-4207
(425) 823-1909
(425) 823-8969
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
9434
WA
1223G0001X
General Practice Dentistry
DE00009434
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5047998
—
WA
Enumeration date
11/08/2006
Last updated
10/09/2012
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