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General NPI Number Information
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NPI Number | 1689480923
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Entity Type | Organization
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Legal Business Name | KESANG NORBHU DMD PLLC
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Dates
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Enumeration Date | 12/10/2024
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Last Update Date | 12/10/2024
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Provider Practice Location Address
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Address Line | 3405 NE 78TH ST
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City | VANCOUVER
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State | WA
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Zip | 98665-0657
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Country | US
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Telephone | 360-574-3061
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Fax |
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Provider Business Mailing Address
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Address Line | 15101 NE 12TH WAY
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City | VANCOUVER
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State | WA
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Zip | 98684-3688
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Country | US
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Telephone | 617-955-5226
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Fax |
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Authorized Official
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Title or Position | N/A
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Name | N/A N/A
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Credential |
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Telephone | --
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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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