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General NPI Number Information
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NPI Number | 1104348739
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Entity Type | Organization
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Legal Business Name | ROSHANAK BAGHAI , PLLC
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Dates
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Enumeration Date | 07/14/2017
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Last Update Date | 07/14/2017
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Provider Practice Location Address
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Address Line | 1340 8TH ST NE STE 102
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City | AUBURN
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State | WA
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Zip | 98002-4700
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Country | US
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Telephone | 253-939-0055
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Fax |
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Provider Business Mailing Address
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Address Line | 1340 8TH ST NE STE 102
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City | AUBURN
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State | WA
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Zip | 98002-4700
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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 | OWNER/DENTIST
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Name | DR. ROSHANAK BAGHAI NAINI
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Credential | DDS, MS
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Telephone | 253-939-0055
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | DE60462907
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License Number State | WA
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