Consolidated Dental Three
Clinic/Center, Dental in Renton, WA. Organization (NPI-2).
NPI number1164039731
StatusActive
Last updated in NPPESSep 28, 2020
Details
- NPI
- 1164039731
- Entity type
- Organization (NPI-2)
- Legal business name
- Consolidated Dental Three
- Organization subpart
- No
- Enumeration date
- Sep 28, 2020
- Certification date
- Sep 28, 2020
- Last updated
- Sep 28, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | – | – | Yes |
Other names
- Valley Dental Center (Doing Business As)
Practice location
19221 108th Ave Se Ste 2Renton, WA 98055-7369
Phone 425-988-0801
Mailing address
19221 108th Ave Se Ste 2Renton, WA 98055-7369
Authorized official
Chelsea D'Nichole Mortell
Owner/ Dentist
2067870132
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