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General NPI Number Information
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NPI Number | 1861909210
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Entity Type | Organization
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Legal Business Name | NASSIM DDS, PS
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Dates
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Enumeration Date | 01/08/2018
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Last Update Date | 01/08/2018
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Provider Practice Location Address
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Address Line | 7030 35TH AVE NE
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City | SEATTLE
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State | WA
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Zip | 98115-5917
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Country | US
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Telephone | 206-229-7977
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Fax |
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Provider Business Mailing Address
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Address Line | 7030 35TH AVE NE
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City | SEATTLE
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State | WA
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Zip | 98115-5917
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Country | US
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Telephone | 206-229-7977
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Fax |
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | NICK PIETSCH
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Credential |
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Telephone | 206-229-7977
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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 | DE00010577
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License Number State | WA
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