Organization
AA BANSAL 2
Active
Other names
PHD COVINGTON LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHRADHA BANSAL DDS (OWNER)
(425) 891-2461
Entity
Organization
Contact information
Practice address
615 WINDSOR DR SE, SAMMAMISH, WA 98074-3422
(253) 326-7777
Mailing address
615 WINDSOR DR SE, SAMMAMISH, WA 98074-3422
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
8920
WA
Other
Enumeration date
05/10/2016
Last updated
05/10/2016
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