Individual
DR. DMITRY PEYSAKHOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1416 HIGHLANDS DR NE, SUITE 120, ISSAQUAH, WA 98029-6240
(781) 856-8080
Mailing address
4047 258TH WAY SE, ISSAQUAH, WA 98029-7763
(781) 856-8080
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DE 60498667
WA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DS038644
PA
Other
Enumeration date
07/22/2008
Last updated
09/02/2015
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