Organization
THIAN SRISURAPOL DDS PLLC
Active
Other names
Premier Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THIAN SRISURAPOL DDS (OWNER/ORTHODONTIST)
(480) 326-3140
Entity
Organization
Contact information
Practice address
23535 NE NOVELTY HILL RD # D308, REDMOND, WA 98053-5502
(425) 868-7770
(425) 868-7718
Mailing address
12819 RENTON AVE S, SEATTLE, WA 98178-4849
(480) 326-3140
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
09/11/2020
Last updated
10/16/2021
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