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General NPI Number Information
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NPI Number | 1033932496
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Entity Type | Organization
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Legal Business Name | ANASTASIYA DOVZHENKO DMD PLLC
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Dates
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Enumeration Date | 11/04/2024
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 7713 CENTER BLVD SE STE 240
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City | SNOQUALMIE
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State | WA
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Zip | 98065-6311
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Country | US
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Telephone | 425-524-4498
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Fax |
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Provider Business Mailing Address
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Address Line | 4165 129TH PL SE APT B102
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City | BELLEVUE
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State | WA
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Zip | 98006-1380
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Country | US
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Telephone | 801-712-7021
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Fax |
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Authorized Official
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Title or Position | OWNER DENTIST
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Name | ANASTASIYA DOVZHENKO
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Credential | DMD
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Telephone | 801-712-7021
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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