Individual
DR. MICHAEL JOSEPH CONWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
5723 NE BOTHELL WAY, SUITE B, KENMORE, WA 98028-9404
(425) 485-0588
(425) 483-6189
Mailing address
5723 NE BOTHELL WAY, SUITE B, KENMORE, WA 98028-9404
(425) 485-0588
(425) 483-6189
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7496
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20-0202013
FEDERAL TAX ID
—
01
—
7496
DENTAL LICENSE
WA
Enumeration date
09/20/2006
Last updated
07/08/2007
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