Individual
DR. RUTILLO O. CHAVES JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
7631 212TH ST SW, SUITE 101-A, EDMONDS, WA 98026-7565
(425) 280-7792
(425) 742-4073
Mailing address
7631 212TH ST SW, SUITE 101-A, EDMONDS, WA 98026-7565
(425) 280-7792
(425) 742-4073
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6200
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
56200
WASHINGTON DENTAL SERVICE
WA
Enumeration date
10/13/2006
Last updated
07/08/2007
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