Organization
RENTON SMILE DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELIZABETH NIKOLAEVA MANCHESTER D.D.S. (DENTIST/OWNER)
(206) 802-8414
Entity
Organization
Contact information
Practice address
1107 SW GRADY WAY, SUITE 250, RENTON, WA 98057-5217
(425) 687-8860
(425) 687-8863
Mailing address
1107 SW GRADY WAY, SUITE 250, RENTON, WA 98057-5217
(425) 687-8860
(425) 687-8863
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DE60475234
WA
Other
Enumeration date
12/30/2014
Last updated
12/30/2014
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