Individual
GENNADIY KALVISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1418 164TH ST SW, SUITE 100, LYNNWOOD, WA 98087-8500
(425) 742-8828
Mailing address
16027 SE 180TH PL, RENTON, WA 98058-9176
(253) 632-8963
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE60572275
WA
Other
Enumeration date
07/02/2015
Last updated
07/02/2015
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