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Organization

THEODORE M HENNESSEY DDS PS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
THEODORE M HENNESSEY DDS (OWNER)
(425) 774-7781
Entity
Organization

Contact information

Practice address
19715 SCRIBER LAKE RD STE C, LYNNWOOD, WA 98036-6165
(425) 774-7781
Mailing address
19715 SCRIBER LAKE RD STE C, LYNNWOOD, WA 98036-6165
(425) 774-7781

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE00010589
WA

Other

Enumeration date
06/17/2012
Last updated
06/17/2012
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