Provider Demographics
NPI:1508319435
Name:MARK WAIND DDS, PS
Entity Type:Organization
Organization Name:MARK WAIND DDS, PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:WAIND
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, PS
Authorized Official - Phone:206-467-8300
Mailing Address - Street 1:720 OLIVE WAY
Mailing Address - Street 2:822
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-1878
Mailing Address - Country:US
Mailing Address - Phone:206-467-8300
Mailing Address - Fax:206-467-7724
Practice Address - Street 1:720 OLIVE WAY
Practice Address - Street 2:#822
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-1878
Practice Address - Country:US
Practice Address - Phone:206-467-8300
Practice Address - Fax:206-467-7724
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-27
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA92751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty