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General NPI Number Information
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NPI Number | 1699446336
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Entity Type | Organization
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Legal Business Name | RENTON SMILES, LLC
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Dates
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Enumeration Date | 09/22/2021
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Last Update Date | 09/22/2021
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Provider Practice Location Address
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Address Line | 10700 SE 174TH ST STE 202
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City | RENTON
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State | WA
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Zip | 98055-5472
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Country | US
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Telephone | 425-264-5163
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Fax | 425-264-5664
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Provider Business Mailing Address
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Address Line | 620 SE EVERETT MALL WAY STE 310
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City | EVERETT
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State | WA
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Zip | 98208-3279
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Country | US
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Telephone | 425-264-5163
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Fax | 425-264-5664
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Authorized Official
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Title or Position | OWNER
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Name | JULIE S HONG
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Credential | DDS
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Telephone | 425-264-5163
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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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