Organization
WASHINGTON DENTAL FEDERAL WAY, LLC
Active
Other names
WA Dental
Organization subpart
No
Provider details
NPI number
Authorized official
YONG PARK (CEO)
(206) 592-2442
Entity
Organization
Contact information
Practice address
31515 PETE VON REICHBAUER WAY S UNIT 108, FEDERAL WAY, WA 98003-5599
(206) 592-2442
Mailing address
4040 ORCHARD ST W STE 200, FIRCREST, WA 98466-6615
(253) 393-2700
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/11/2019
Last updated
09/11/2019
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