Organization
GENTLE ENDODONTICS OF KENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VAHID ATABAKHSH (OWNER)
(253) 852-1332
Entity
Organization
Contact information
Practice address
24401 104TH AVE SE, SUITE 202, KENT, WA 98030-4903
(253) 850-6999
Mailing address
24401 104TH AVE SE, SUITE 202, KENT, WA 98030-4903
(253) 850-6999
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
60103522
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104292887
ENDODONTIST
WA
01
—
1710049119
ENDODONTIST
WA
Enumeration date
09/14/2016
Last updated
09/14/2016
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