Individual
KAYLA NICOLE RUSSELL BONHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
3819 NE 45TH ST, SEATTLE, WA 98105-5144
(206) 524-6116
Mailing address
3819 NE 45TH ST STE A, SEATTLE, WA 98105-5144
(206) 524-6116
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE60865965
WA
Other
Enumeration date
07/17/2018
Last updated
03/31/2022
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