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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