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General NPI Number Information
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NPI Number | 1548335169
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Entity Type | Organization
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Legal Business Name | AFFORDABLE DENTAL CARE
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 06/16/2008
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Provider Practice Location Address
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Address Line | 15726 1ST AVE S
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City | BURIEN
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State | WA
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Zip | 98148
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Country | US
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Telephone | 206-988-0500
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Fax | 206-988-0504
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Provider Business Mailing Address
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Address Line | 15726 1ST AVE S
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City | BURIEN
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State | WA
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Zip | 98148
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Country | US
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Telephone | 206-988-0500
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Fax | 206-988-0504
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Authorized Official
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Title or Position | OPERATIONS MANAGER
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Name | MS. BECKY A LILLIE
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Credential |
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Telephone | 253-630-3500
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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 | 7186
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License Number State | WA
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