Organization
DAVINCI DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BEAU JEROME KELLER DDS (DENTIST)
(425) 409-9999
Entity
Organization
Contact information
Practice address
909 112TH AVE NE STE P104, DAVINCI DENTAL, BELLEVUE, WA 98004-8589
(425) 409-9999
Mailing address
909 112TH AVE NE STE P104, DAVINVI DENTAL, BELLEVUE, WA 98004-8589
(425) 409-9999
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
60555911
WA
Other
Enumeration date
06/08/2015
Last updated
06/08/2015
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