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Individual

ALLYSON STEWART DKEIDEK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
4500 SAND POINT WAY NE, SUITE 208, SEATTLE, WA 98105-3900
(206) 525-4777
Mailing address
1615 E HIGHLAND DR, SEATTLE, WA 98112-3323
(716) 725-4676

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
12011261A
IN
122300000X
Dentist
Primary
6197-15
WI
122300000X
Dentist
DE60124299
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2008604
WA
05
33386500
WI
05
33730800
WI
05
33794900
WI
Enumeration date
03/03/2008
Last updated
02/28/2012
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