Organization
FAIRWOOD ORTHODONTICS
Active
Other names
Mercer Island Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
MARIO D CHORAK DMD (ORTHODONTIST OWNER)
(425) 235-8800
Entity
Organization
Contact information
Practice address
14300 SE PETROVITSKY ROAD, RENTON, WA 98058
(425) 235-8800
(425) 235-0288
Mailing address
14300 SE PETROVITSKY ROAD, RENTON, WA 98058
(425) 235-8800
(425) 235-0288
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DE00008957
WA
Other
Enumeration date
12/12/2006
Last updated
08/08/2008
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