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General NPI Number Information
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NPI Number | 1093293748
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Entity Type | Organization
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Legal Business Name | SONU MATHUR DDS PLLC
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Dates
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Enumeration Date | 08/04/2018
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Last Update Date | 08/04/2018
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Provider Practice Location Address
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Address Line | 11066 5TH AVE NE STE 102
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City | SEATTLE
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State | WA
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Zip | 98125-6156
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Country | US
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Telephone | 206-362-8200
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Fax |
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Provider Business Mailing Address
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Address Line | 5114 192ND DR NE
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City | SAMMAMISH
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State | WA
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Zip | 98074-4638
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | GOVERNING PERSON
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Name | SONU MATHUR
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Credential |
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Telephone | 425-830-4104
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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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