Organization
DELTA DENTAL OF WASHINGTON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRADLEY A BERG (COO & CFO)
(206) 528-2340
Entity
Organization
Contact information
Practice address
9706 4TH AVE NE, SEATTLE, WA 98115-2157
(206) 528-2351
Mailing address
9706 4TH AVE NE, SEATTLE, WA 98115-2157
(206) 528-2351
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10261666
—
WA
Enumeration date
05/11/2016
Last updated
05/11/2016
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