Organization
MILL CREEK IMPLANTS & PERIODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA OCTAVIA REAMES (OFFICE MANAGER)
(425) 354-5704
Entity
Organization
Contact information
Practice address
15130 MAIN ST STE 210, MILL CREEK, WA 98012-7370
(425) 354-5704
Mailing address
15130 MAIN ST STE 210, MILL CREEK, WA 98012-7370
(425) 354-5704
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
DE60455178
WA
Other
Enumeration date
09/13/2016
Last updated
09/13/2016
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