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General NPI Number Information
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NPI Number | 1215485792
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Entity Type | Organization
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Legal Business Name | LEONE AND VAUGHN ORTHODONTICS
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Dates
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Enumeration Date | 09/14/2016
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Last Update Date | 09/14/2016
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Provider Practice Location Address
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Address Line | 600 108TH AVE NE STE 120
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City | BELLEVUE
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State | WA
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Zip | 98004-5110
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Country | US
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Telephone | 425-450-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 600 108TH AVE NE STE 120
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City | BELLEVUE
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State | WA
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Zip | 98004
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Country | US
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Telephone | 425-450-1000
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Fax |
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Authorized Official
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Title or Position | FINACIAL COORDINATOR
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Name | JOAN FULLER
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Credential |
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Telephone | 206-285-5000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DE00009047
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License Number State | WA
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