Individual
DR. MICAH BOVENKAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6222 NE 74TH ST, SEATTLE, WA 98115-8158
(206) 543-5800
Mailing address
6222 NE 74TH ST # 354915, SEATTLE, WA 98115-8158
(206) 543-7906
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DR61043609
WA
Other
Enumeration date
03/31/2020
Last updated
03/31/2020
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