Organization
GREEN LAKE FAMILY AND COSMETIC DENTISTRY
Active
Other names
Green Lake Cosmetic Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHERRYL SUE ELLISON DDS (DENTIST OWNER)
(812) 272-4602
Entity
Organization
Contact information
Practice address
8018 AURORA AVE N, SEATTLE, WA 98103-4350
(206) 258-4207
Mailing address
8018 AURORA AVE N, SEATTLE, WA 98103-4350
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
03/24/2025
Last updated
03/24/2025
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