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General NPI Number Information
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NPI Number | 1295941235
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Entity Type | Organization
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Legal Business Name | DEBRA M. ENNEKING, D.D.S.,P.L.L.C.
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2425 33RD AVE W STE A1
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City | SEATTLE
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State | WA
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Zip | 98199-3255
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Country | US
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Telephone | 206-283-7844
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Fax | 206-283-9233
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Provider Business Mailing Address
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Address Line | 2425 33RD AVE W STE A1
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City | SEATTLE
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State | WA
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Zip | 98199-3255
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Country | US
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Telephone | 206-283-7844
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Fax | 206-283-9233
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. DEBRA M ENNEKING
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Credential | D.D.S.
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Telephone | 206-283-7844
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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 | 7066
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License Number State | WA
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