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General NPI Number Information
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NPI Number | 1437386208
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Entity Type | Organization
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Legal Business Name | MICHAEL J. SCOLES DMD RENTON LLC
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Dates
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Enumeration Date | 06/18/2009
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Last Update Date | 06/18/2009
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Provider Practice Location Address
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Address Line | 300 PELLY AVE N
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City | RENTON
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State | WA
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Zip | 98057-5700
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Country | US
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Telephone | 425-228-6444
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Fax | 425-226-3602
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Provider Business Mailing Address
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Address Line | 300 PELLY AVE N
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City | RENTON
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State | WA
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Zip | 98057-5700
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Country | US
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Telephone | 425-228-6444
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Fax | 425-226-3602
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Authorized Official
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Title or Position | DENTIST
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Name | DR. MICAEL J SCOLES
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Credential | D.M.D.
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Telephone | 425-228-6444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 9010
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License Number State | WA
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