Organization
GOLDEN YEARS SMILES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KALA WILSON (CO-OWNER)
(425) 345-6484
Entity
Organization
Contact information
Practice address
22131 OLD OWEN RD, MONROE, WA 98272-9625
(425) 345-6484
Mailing address
PO BOX 793, LYNNWOOD, WA 98046-0793
(425) 343-7510
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
00006928
WA
Other
Enumeration date
02/04/2014
Last updated
02/04/2014
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