Provider Demographics
NPI:1235684788
Name:JURGA MARTINI DMD PS
Entity Type:Organization
Organization Name:JURGA MARTINI DMD PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JURGA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-464-9002
Mailing Address - Street 1:1220 HOWELL ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-1469
Mailing Address - Country:US
Mailing Address - Phone:206-464-9002
Mailing Address - Fax:
Practice Address - Street 1:1220 HOWELL ST
Practice Address - Street 2:SUITE 110
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-1469
Practice Address - Country:US
Practice Address - Phone:206-464-9002
Practice Address - Fax:206-464-9003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-24
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA87041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty