Organization
SUNSET DENTAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HOMAYOON FOTOVATJAH D.D.S (OWNER)
(425) 227-9774
Entity
Organization
Contact information
Practice address
1314 UNION AVE NE, SUITE 8, RENTON, WA 98059-3959
(425) 227-9774
Mailing address
1314 UNION AVE NE, SUITE 8, RENTON, WA 98059-3959
(425) 227-9774
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE 00006854
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5019823
—
WA
Enumeration date
05/05/2010
Last updated
05/05/2010
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