Organization
NORTHWEST INSTITUTE OF COSMETIC DENTISTRY
Active
Other names
Eric Der Ovanessian DDS PS Inc
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERIC DER OVANESSIAN DDS (PRESIDENT)
(425) 643-7100
Entity
Organization
Contact information
Practice address
15710 NE 24TH STREET, #B, BELLEVUE, WA 98008
(425) 643-7100
(425) 644-1426
Mailing address
15710 NE 24TH STREET, #B, BELLEVUE, WA 98008
(425) 643-7100
(425) 644-1426
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
39144
CA
122300000X
Dentist
Primary
7600
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5034913
—
WA
Enumeration date
11/16/2006
Last updated
08/06/2012
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