Provider Demographics
NPI:1427360148
Name:KING PLAZA DENTAL & DENTURES
Entity Type:Organization
Organization Name:KING PLAZA DENTAL & DENTURES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DAISY
Authorized Official - Middle Name:B
Authorized Official - Last Name:CANCIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-722-8858
Mailing Address - Street 1:7101 ML KING JR. WAY SOUTH
Mailing Address - Street 2:SUITE 211
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118
Mailing Address - Country:US
Mailing Address - Phone:206-722-8858
Mailing Address - Fax:206-722-0992
Practice Address - Street 1:7101 ML KING JR. WAY SOUTH
Practice Address - Street 2:SUITE 211
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118
Practice Address - Country:US
Practice Address - Phone:206-722-8858
Practice Address - Fax:206-722-0992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-10
Last Update Date:2010-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty