Individual
MARK J SEBASTIAN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
33516 9TH AVE S, WESTHILL COURT BLDG 2, FEDERAL WAY, WA 98003-6322
(253) 941-6242
(253) 952-2129
Mailing address
33516 9TH AVE S, WESTHILL COURT BLDG 2, FEDERAL WAY, WA 98003-6322
(253) 941-6242
(253) 952-2129
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5374
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0040673
LABOR & INDUSTRIES
WA
Enumeration date
11/28/2005
Last updated
07/08/2007
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