Organization
WESTSIDE SMILE DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHONG ANH VONG LD (DENTURIST)
(206) 762-7222
Entity
Organization
Contact information
Practice address
9670 14TH AVE SW UNIT AB, SEATTLE, WA 98106-2876
(206) 762-7222
(206) 762-7783
Mailing address
9670 14TH AVE SW UNIT AB, SEATTLE, WA 98106-2876
(206) 762-7222
(206) 762-7783
Taxonomy
Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
DN327
WA
Other
Enumeration date
03/19/2009
Last updated
03/19/2009
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