| NPI | 1063657393 |
|---|---|
| Doing Business As | BELLEVUE KIDS DENTIST |
| Entity Type | Organization |
| Authorized Contact | LA NETTE MCINTOSH Regional Office Manager 425-396-1011 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: WA DE00008547) |
| Enumeration Date | 2008-12-16 |
| Last Update Date | 2020-12-30 |