| NPI | 1831423292 |
|---|---|
| Doing Business As | EASTSIDE PEDIATRIC DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | LANETTE MCINTOSH Regional Operations Manager 425-396-1011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: WA 6912) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: WA 6870) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: WA 8235) | |
| Enumeration Date | 2009-10-01 |
| Last Update Date | 2021-02-25 |