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General NPI Number Information
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NPI Number | 1326249731
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Entity Type | Organization
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Legal Business Name | PADMARAJ V. ANGOLKAR D.D.S., M.D.S.
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Dates
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Enumeration Date | 05/31/2007
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Last Update Date | 10/14/2010
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Provider Practice Location Address
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Address Line | 505 E SUNSET WAY
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City | ISSAQUAH
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State | WA
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Zip | 98027-3438
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Country | US
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Telephone | 425-392-0980
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Fax | 425-392-0671
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Provider Business Mailing Address
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Address Line | 505 E SUNSET WAY
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City | ISSAQUAH
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State | WA
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Zip | 98027-3438
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Country | US
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Telephone | 425-392-0980
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Fax | 425-392-0671
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | DR. PADMARAJ (RAJ) V. ANGOLKAR
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Credential | D.D.S., M.D.S.
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Telephone | 425-392-0980
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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 | DE00005781
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License Number State | WA
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