Individual
EDWARD IM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1200 112TH AVE NE, SUITE C-222, BELLEVUE, WA 98004-3732
(425) 450-9500
(425) 450-5008
Mailing address
1200 112TH AVE NE, SUITE C-222, BELLEVUE, WA 98004-3732
(425) 450-9500
(425) 450-5008
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE9961
WA
Other
Enumeration date
11/16/2006
Last updated
07/08/2007
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