Provider Demographics
NPI:1083047989
Name:BUCHANAN AND KIM, DDS, PLLC
Entity Type:Organization
Organization Name:BUCHANAN AND KIM, DDS, PLLC
Other - Org Name:GATEWAY DENTAL CENTRE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:M
Authorized Official - Last Name:MULLIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-343-8929
Mailing Address - Street 1:700 5TH AVE
Mailing Address - Street 2:SUITE 1616
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-5058
Mailing Address - Country:US
Mailing Address - Phone:206-343-8929
Mailing Address - Fax:
Practice Address - Street 1:700 5TH AVE
Practice Address - Street 2:SUITE 1616
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-5058
Practice Address - Country:US
Practice Address - Phone:206-343-8929
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-14
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA6807261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental