Healthcare Provider Details

I. General information

NPI: 1578020632
Provider Name (Legal Business Name): ABU & DEL ROSARIO, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2019
Last Update Date: 02/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1220 HOWELL ST STE 110
SEATTLE WA
98101-1407
US

IV. Provider business mailing address

1220 HOWELL ST STE 110
SEATTLE WA
98101-1407
US

V. Phone/Fax

Practice location:
  • Phone: 206-754-6024
  • Fax:
Mailing address:
  • Phone: 206-754-6024
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: ALFADHLI ABU
Title or Position: DENTIST/CO-OWNER
Credential: DDS
Phone: 425-739-9093