Provider First Line Business Practice Location Address:
1959 NE PACIFIC STREET UNIVERSITY OF WASHINGTON
Provider Second Line Business Practice Location Address:
D779A, BOX 357456, RESTORATIVE DENTISTRY
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98195-7456
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-543-5948
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/07/2006