Organization
GREEN LAKE FACIAL SURGERY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW SHANE EPSTEIN DDS (OWNER)
(120) 696-3906
Entity
Organization
Contact information
Practice address
7900 E GREEN LAKE DR N, SUITE 302, SEATTLE, WA 98103-4800
(206) 693-3906
Mailing address
7900 E GREEN LAKE DR N, SUITE 302, SEATTLE, WA 98103-4800
(206) 693-3906
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DE 60277222
WA
Other
Enumeration date
03/25/2014
Last updated
03/25/2014
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