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General NPI Number Information
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NPI Number | 1316447758
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Entity Type | Organization
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Legal Business Name | 3D ENDODONTICS
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Dates
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Enumeration Date | 02/12/2018
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Last Update Date | 02/12/2018
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Provider Practice Location Address
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Address Line | 451 DUVALL AVE NE STE 120
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City | RENTON
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State | WA
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Zip | 98059-4675
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Country | US
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Telephone | 720-470-6767
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Fax |
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Provider Business Mailing Address
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Address Line | 11302 SE 79TH PL
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City | NEWCASTLE
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State | WA
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Zip | 98056-9124
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Country | US
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Telephone | 720-470-6767
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | HELENA BECKER
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Credential | DMD
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Telephone | 720-470-6767
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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 |
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License Number State |
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