Individual
MILES RICHARD DI SABELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
126 AUBURN AVE STE 100, AUBURN, WA 98002-5082
(142) 527-7131
Mailing address
955 POWELL AVE SW, RENTON, WA 98057-2908
(425) 277-1311
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE61067130
WA
1223G0001X
General Practice Dentistry
DE61067130
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/02/2019
Last updated
01/21/2025
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