Organization
BAJWA WONG PLLC
Active
Other names
Eastside Modern Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
SOFIA SEGURA (CREDENTIALING MANAGER)
(509) 901-2239
Entity
Organization
Contact information
Practice address
640 NW GILMAN BLVD STE 100, ISSAQUAH, WA 98027-2476
(425) 507-2888
(425) 507-2887
Mailing address
640 NW GILMAN BLVD STE 100, ISSAQUAH, WA 98027-2476
(425) 507-2888
(425) 507-2887
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
04/20/2020
Last updated
04/20/2020
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