Individual
DR. BRIAN T POVOLNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS MSD PHD
Contact information
Practice address
411 STRANDER BLVD SUITE 104, TUKWILA, WA 98188
(206) 575-1515
(206) 575-1219
Mailing address
411 STRANDER BLVD SUITE 104, TUKWILA, WA 98188
(206) 575-1515
(206) 575-1219
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DE00005752
WA
Other
Enumeration date
09/21/2006
Last updated
07/08/2007
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