Organization
QUIL CEDA FAMILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONALD A. SEBASTIAN DDS (DENTIST)
(360) 659-1149
Entity
Organization
Contact information
Practice address
8825 34TH AVE NE STE M, TULALIP, WA 98271-8085
(360) 659-1149
(360) 716-3626
Mailing address
8825 34TH AVE NE STE M, TULALIP, WA 98271-8085
(360) 659-1149
(360) 716-3626
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
10444
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
77045
—
WA
Enumeration date
08/06/2010
Last updated
08/06/2010
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