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Individual

IRFAN YUSOFF

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1400 N LAVENTURE RD, MOUNT VERNON, WA 98273-2766
(360) 542-8901
Mailing address
PO BOX 34703, SEATTLE, WA 98124-1703
(253) 681-6603

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE60478709
WA
1223G0001X
General Practice Dentistry
DE60478709
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1012821
WA
Enumeration date
07/10/2014
Last updated
04/22/2025
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