| Crystal Dental Inc. | |
|
12644 164th Ave Se Renton WA 98059-6403 | |
| (425) 282-4182 | |
| (425) 572-6072 |
| Full Name | Crystal Dental Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 12644 164th Ave Se, Renton, Washington |
| Authorized Official Name and Position | Chris Joon Lee (DENTIST) |
| Authorized Official Contact | 4252824182 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Crystal Dental Inc. 12644 164th Ave Se Renton WA 98059-6403 Ph: (425) 282-4182 | Crystal Dental Inc. 12644 164th Ave Se Renton WA 98059-6403 Ph: (425) 282-4182 |
| NPI Number | 1184047466 |
|---|---|
| Provider Enumeration Date | 01/23/2014 |
| Last Update Date | 01/23/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184047466 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DE60389882 (Washington) | Primary |
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