| NPI | 1154825321 |
|---|---|
| Doing Business As | ICON DENTAL CENTER |
| Entity Type | Organization |
| Authorized Contact | JACKY A CHAN Financial Coordinator 425-337-2400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WA 60383042) |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2018-03-21 |