Individual
MICHAEL J MIYAMOTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.D.
Contact information
Practice address
24837 104TH AVE SE STE 200, KENT, WA 98030-6800
(253) 850-1234
Mailing address
24837 104TH AVE SE STE 200, KENT, WA 98030-6800
(253) 850-1234
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DE60904232
WA
Other
Enumeration date
12/13/2011
Last updated
03/18/2019
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