Organization
DENTISTRY @ RENTON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA GRAY (TEAM LEADER)
(253) 236-7456
Entity
Organization
Contact information
Practice address
19221 108TH AVE SE STE 4, RENTON, WA 98055-7369
(253) 852-4746
Mailing address
21230 STATE ROUTE 410 E, BONNEY LAKE, WA 98391-8789
(253) 236-7456
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
04/01/2022
Last updated
04/26/2022
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