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General NPI Number Information
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NPI Number | 1649120494
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Entity Type | Organization
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Legal Business Name | COAL CREEK DENTISTRY
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Dates
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Enumeration Date | 01/31/2026
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Last Update Date | 01/31/2026
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Provider Practice Location Address
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Address Line | 6920 COAL CREEK PKWY SE STE 14
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City | NEWCASTLE
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State | WA
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Zip | 98059-3147
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Country | US
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Telephone | 425-641-4304
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Fax |
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Provider Business Mailing Address
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Address Line | 2013 BELLEVUE WAY NE
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City | BELLEVUE
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State | WA
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Zip | 98004-2823
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Country | US
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Telephone |
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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. CHRISTINE JANE CAO
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Credential | DMD
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Telephone | 626-400-9471
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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 |
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License Number State |
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