Organization
ABC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LUC HOANG (CEO)
(206) 878-5665
Entity
Organization
Contact information
Practice address
22625 PACIFIC HWY S, DES MOINES, WA 98198-5110
(206) 878-5665
(206) 870-1504
Mailing address
22625 PACIFIC HWY S, DES MOINES, WA 98198-5110
(206) 878-5665
(206) 870-1504
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
2855
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5040043
—
WA
Enumeration date
04/12/2007
Last updated
08/22/2020
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