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NPI Code Detail

MEDICARE: BELLA MAKAGON DMD

MEDICARE: BELLA MAKAGON DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice DentistryDE60058471WA

General Provider Information

NPI Number : 1083800049
Entity Type Code : Individual
Provider Name (Legal Business Name) : BELLA MAKAGON DMD
Provider Business Mailing Address
First Line : 116 FAIRVIEW AVE N
Second Line : SUITE 148
City : SEATTLE
State : WA
Zip : 98109-5360
Country : US
Telephone Number : 206-682-7942
Fax Number : 206-701-7965
Provider Business Practice Location Address
First Line : 116 FAIRVIEW AVE N
Second Line : SUITE 148
City : SEATTLE
State : WA
Zip : 98109-5360
Country : US
Telephone Number : 206-682-7942
Fax Number : 206-701-7965
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2007
Last Update Date : 01/10/2012

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Directions to “ BELLA MAKAGON DMD” Practice Location

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