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General NPI Number Information
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NPI Number | 1679421705
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Entity Type | Organization
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Legal Business Name | ADVANCED DENTAL ARTISTRY
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Dates
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Enumeration Date | 03/16/2026
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Last Update Date | 03/16/2026
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Provider Practice Location Address
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Address Line | 118 SW 330TH ST STE 103
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City | FEDERAL WAY
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State | WA
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Zip | 98023-6185
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Country | US
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Telephone | 253-835-2296
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Fax | 253-835-7103
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Provider Business Mailing Address
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Address Line | 118 SW 330TH ST STE 103
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City | FEDERAL WAY
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State | WA
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Zip | 98023-6185
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Country | US
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Telephone | 253-835-2296
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Fax | 253-835-7103
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Authorized Official
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Title or Position | MANAGER
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Name | WENDY GRISHAM
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Credential |
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Telephone | 253-835-2295
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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 |
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License Number State |
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