Individual
STACEY K UM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
910 MADISON ST, EVERETT, WA 98203-4542
(425) 355-5520
(425) 355-5532
Mailing address
910 MADISON ST, EVERETT, WA 98203-4542
(425) 355-5520
(425) 355-5532
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE00007510
WA
Other
Enumeration date
08/10/2006
Last updated
07/08/2007
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