Organization
DALE K TRAVIS DDS PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DALE KENNETH TRAVIS DDS (DENTIST / OWNER)
(425) 483-5959
Entity
Organization
Contact information
Practice address
17416 135TH AVE NE, STE 201, WOODINVILLE, WA 98072
(425) 483-5959
(425) 806-5440
Mailing address
PO BOX 606, WOODINVILLE, WA 98072
(425) 483-5959
(425) 806-5440
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DE00005037
WA
1223G0001X
General Practice Dentistry
Primary
DE00005037
WA
Other
Enumeration date
09/12/2006
Last updated
06/01/2012
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