Individual
DR. ANDREW PETER SHOLUDKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
10830 19TH AVE SE, SUITE A, EVERETT, WA 98208-5181
(774) 278-0412
Mailing address
10830 19TH AVE SE, SUITE A, EVERETT, WA 98208-5181
(774) 278-0412
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE60484387
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DE6484387
WA DENTAL LICENSE
WA
Enumeration date
07/16/2013
Last updated
03/07/2023
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