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General NPI Number Information
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NPI Number | 1558780585
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Entity Type | Organization
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Legal Business Name | BRANDON TOMI YAMAMURA DDS, MSD, PLLC
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Dates
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Enumeration Date | 04/07/2014
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Last Update Date | 04/07/2014
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Provider Practice Location Address
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Address Line | 221 2ND AVE S STE 101
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City | KENT
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State | WA
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Zip | 98032-5873
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Country | US
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Telephone | 253-854-2057
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Fax |
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Provider Business Mailing Address
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Address Line | 221 2ND AVE S STE 101
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City | KENT
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State | WA
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Zip | 98032-5873
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Country | US
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Telephone | 253-854-2057
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. BRANDON YAMAMURA
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Credential | DDS, MSD
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Telephone | 425-765-2303
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | DE60205619
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License Number State | WA
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