Individual
DR. TREVOR DYLAN KANACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
220 BROADWAY E, SEATTLE, WA 98102-5724
(206) 686-3828
Mailing address
820 BLANCHARD ST UNIT 1501, SEATTLE, WA 98121-2656
(469) 369-6671
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
33233
TX
1223G0001X
General Practice Dentistry
Primary
DE60839553
WA
Other
Enumeration date
07/11/2017
Last updated
03/19/2018
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