Theodore M Hennessey Dds Ps

NPI 1255694147 - Dentist - 1223G0001X

NPI Details
NPI 1255694147
Enumeration Date 06/17/2012
Last Updated 06/17/2012
Entity Type Healthcare Provider
Active Over 4 years ago
Authorized Information
Name THEODORE M THEODORE
Position OWNER
Phone (425) 774-7781
Fax
Practice Location
19715 SCRIBER LAKE RD STE C
LYNNWOOD WA, 98036-6165, US
Phone (425) 774-7781
Fax
Business Location
19715 SCRIBER LAKE RD STE C
LYNNWOOD WA, 98036-6165, US
Phone (425) 774-7781
Fax
Toxanomy
Taxonomy Code 1223G0001X
License State Washington
License Number DE00010589
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According to our database, Theodore M Hennessey Dds Ps NPI is 1255694147, taxonomy code is 1223G0001X and license number is DE00010589, license state is located at Washington. Theodore M Hennessey Dds Ps physically located at 19715 Scriber Lake Rd Ste C, Lynnwood WA, 98036-6165. NPI Number 1033115704 has the healthcare provider type.

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1255694147 NPI number is provided on an as is basis without warranty of any kind. 1255694147 is maintained by the National Plan & Provider Enumeration System. The contents of Theodore M Hennessey Dds Ps are for informational purposes only.