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General NPI Number Information
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NPI Number | 1134901309
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Entity Type | Individual
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Provider Name | COLE THOMAS HUBER DD
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Gender | Male
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Dates
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Enumeration Date | 10/20/2023
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Last Update Date | 10/20/2023
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Provider Practice Location Address
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Address Line | 17800 TALBOT RD S # G
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City | RENTON
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State | WA
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Zip | 98055-5740
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Country | US
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Telephone | 425-793-9433
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Fax |
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Provider Business Mailing Address
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Address Line | 23225 166TH AVE SE
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City | KENT
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State | WA
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Zip | 98042-4701
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Country | US
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Telephone | 253-886-9360
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122400000X
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Taxonomy Name | Denturist
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License Number | DN.61451707
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License Number State | WA
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