Organization
KENT K KUSAKABE D.D.S., P.S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENT KOSHI KUSAKABE D.D.S. (PRESIDENT)
(206) 660-4488
Entity
Organization
Contact information
Practice address
8435 161ST AVE NE STE 2, REDMOND, WA 98052-1513
(206) 660-4488
Mailing address
8831 206TH ST SE APT B, SNOHOMISH, WA 98296-5167
(206) 660-4488
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
603288637
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5001813
—
WA
Enumeration date
05/02/2013
Last updated
05/02/2013
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