Organization
AHDUT BEAN PLLC
Active
Other names
Green Leaf Dental, Green Leaf Kids
Organization subpart
No
Provider details
NPI number
Authorized official
DR. YONATAN NIR AHDUT DDS (DENTIST/OWNER)
(253) 426-5821
Entity
Organization
Contact information
Practice address
4219 S OTHELLO ST STE 105D, SEATTLE, WA 98118-3873
(206) 316-2351
Mailing address
4219 S OTHELLO ST STE 105D, SEATTLE, WA 98118-3873
(206) 316-2351
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DE60479557
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2036949
—
WA
Enumeration date
06/27/2018
Last updated
06/11/2019
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