Individual
DR. IDIN ZHALEHDOUST SANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
18008 STATE ROUTE 410 E STE B, BONNEY LAKE, WA 98391-7113
(253) 826-5000
Mailing address
18008 STATE ROUTE 410 E STE B, BONNEY LAKE, WA 98391-7113
(253) 826-5000
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
059985
NY
1223P0221X
Pediatric Dentistry
Primary
DE60752640
WA
Other
Enumeration date
02/17/2016
Last updated
07/24/2020
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