Organization
REVIVE SMILES DENTISTRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BILL S WONG DDS (OWNER/DDS)
(206) 829-8565
Entity
Organization
Contact information
Practice address
259 YALE AVE N, SEATTLE, WA 98109-5430
(206) 829-8565
Mailing address
259 YALE AVE N, SEATTLE, WA 98109-5430
(206) 829-8565
(206) 739-5797
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
9084
WA
Other
Enumeration date
10/20/2017
Last updated
03/19/2021
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