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General NPI Number Information
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NPI Number | 1083407019
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Entity Type | Organization
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Legal Business Name | SERENA THAM DMD PLLC
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Dates
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Enumeration Date | 05/23/2025
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Last Update Date | 05/23/2025
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Provider Practice Location Address
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Address Line | 5429 CALIFORNIA AVE SW
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City | SEATTLE
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State | WA
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Zip | 98136-1512
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Country | US
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Telephone | 206-935-8800
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Fax |
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Provider Business Mailing Address
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Address Line | 4710 NE 40TH ST
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City | SEATTLE
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State | WA
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Zip | 98105-5215
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Country | US
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Telephone | 626-232-6507
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SERENA THAM
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Credential | DMD
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Telephone | 626-232-6507
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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