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Organization

IM GHORBANIAN KAHLON DDS PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SARAH IM (OFFICE MANAGER)
(425) 669-9015
Entity
Organization

Contact information

Practice address
404 MAIN AVE S, NORTH BEND, WA 98045-8215
(425) 669-9015
Mailing address
404 MAIN AVE S, NORTH BEND, WA 98045-8215
(425) 669-9015

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1013323518
NPI INDIVIDUAL
WA
01
1023149358
NPI INDIVIDUAL
WA
01
1275606188
NPI INDIVIDUAL
WA
01
1518111541
NPI INDIVIDUAL
WA
Enumeration date
03/19/2018
Last updated
03/19/2018
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