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General NPI Number Information
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NPI Number | 1326249723
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Entity Type | Organization
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Legal Business Name | TUTLAND THOMAS
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Dates
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Enumeration Date | 05/31/2007
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Last Update Date | 07/11/2008
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Provider Practice Location Address
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Address Line | 13126 120TH AVE NE
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City | KIRKLAND
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State | WA
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Zip | 98034-3014
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Country | US
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Telephone | 425-821-2526
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Fax | 425-820-9114
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Provider Business Mailing Address
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Address Line | 13126 120TH AVE NE
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City | KIRKLAND
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State | WA
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Zip | 98034-3014
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Country | US
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Telephone | 425-821-2526
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Fax | 425-820-9114
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Authorized Official
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Title or Position | OWNER
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Name | DR. TROY W THOMAS
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Credential | DMD
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Telephone | 425-821-2526
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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 | 9361
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License Number State | WA
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