Organization
HOUSE, LEE, MAST, MCDONALD AND NELSON, PC
Active
Organization
HOUSE, LEE, MAST, MCDONALD AND NELSON, PC
Active
Other names
Fairwood Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
LANETTE MCINTOSH (REG. OPS MANAGER)
(425) 396-1011
Entity
Organization
Contact information
Practice address
14300 SE PETROVITSKY RD, RENTON, WA 98058-8955
(425) 235-8800
Mailing address
14300 SE PETROVITSKY RD, RENTON, WA 98058-8955
(425) 235-8800
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
03/31/2021
Last updated
04/01/2021
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