Organization
TREE HOUSE DENTISTRY FOR KIDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL BENJAMINE AUSTIN DMD (MEMBER)
(801) 550-4702
Entity
Organization
Contact information
Practice address
20214 BALLINGER WAY NE, SHORELINE, WA 98155-1144
(206) 466-6250
Mailing address
20214 BALLINGER WAY NE, SHORELINE, WA 98155-1144
(206) 466-6250
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DE60377097
WA
1223D0004X
Dental Anesthesiology
GA60407769
WA
1223G0001X
General Practice Dentistry
DE60384474
WA
1223P0221X
Pediatric Dentistry
Primary
DE60377097
WA
Other
Enumeration date
12/21/2016
Last updated
12/21/2016
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