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Organization

A D LIOU DDS MSD PS

Active
Other names
Edmonds Prosthodontics
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. BRENDA L HECKATHORN (OFFICE MANAGER)
(425) 776-3166
Entity
Organization

Contact information

Practice address
22815 100TH AVE W, EDMONDS, WA 98020-5919
(425) 776-3166
(425) 776-3881
Mailing address
22815 100TH AVE W, EDMONDS, WA 98020-5919
(425) 776-3166
(425) 776-3881

Taxonomy

Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
00006629
WA

Other

Enumeration date
02/14/2013
Last updated
02/14/2013
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