Individual
M JACK WILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1700 NW 56TH ST, SEATTLE, WA 98026
(206) 783-0400
(206) 783-1929
Mailing address
1700 NW 56TH ST, SEATTLE, WA 98026
(206) 783-0400
(206) 783-1929
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6147
WA
Other
Enumeration date
11/20/2006
Last updated
07/08/2007
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