Individual
TODD B KREKOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
11102 NE 38TH PL, BELLEVUE, WA 98004-7653
(425) 828-3705
Mailing address
11102 NE 38TH PL, BELLEVUE, WA 98004-7653
(425) 828-3705
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
D2046
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
912023
AHCCCS ID #
AZ
Enumeration date
12/22/2006
Last updated
07/08/2007
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