Provider Demographics
NPI:1508381716
Name:MICHAEL S. KORN, D.D.S., P.L.L.C.
Entity Type:Organization
Organization Name:MICHAEL S. KORN, D.D.S., P.L.L.C.
Other - Org Name:MICHAEL KORN, DDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:AMADOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-433-5595
Mailing Address - Street 1:6720 FORT DENT WAY STE 210
Mailing Address - Street 2:
Mailing Address - City:TUKWILA
Mailing Address - State:WA
Mailing Address - Zip Code:98188-2580
Mailing Address - Country:US
Mailing Address - Phone:206-433-5595
Mailing Address - Fax:206-433-0537
Practice Address - Street 1:6720 FORT DENT WAY STE 210
Practice Address - Street 2:
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98188-2580
Practice Address - Country:US
Practice Address - Phone:206-433-5595
Practice Address - Fax:206-433-0537
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental