Organization
BOTHELL DENTURE CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SATOMI HIRAI LD (LICENSED DENTURIST)
(425) 483-4643
Entity
Organization
Contact information
Practice address
10137 MAIN ST, SUITE 7, BOTHELL, WA 98011-3422
(425) 483-4643
(425) 483-1493
Mailing address
10137 MAIN ST, SUITE 7, BOTHELL, WA 98011-3422
(425) 483-4643
(425) 483-1493
Taxonomy
Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
DN000258
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5036835
—
WA
Enumeration date
10/12/2006
Last updated
08/22/2020
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