Provider Demographics
NPI:1609392083
Name:HWANG-BOTHELL PLLC
Entity Type:Organization
Organization Name:HWANG-BOTHELL PLLC
Other - Org Name:GENTLE TOUCH DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:Y
Authorized Official - Last Name:HWANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-641-5140
Mailing Address - Street 1:17917 BOTHELL EVERETT HWY STE 305
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98012-6379
Mailing Address - Country:US
Mailing Address - Phone:425-481-1038
Mailing Address - Fax:425-483-3158
Practice Address - Street 1:17917 BOTHELL EVERETT HWY STE 305
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98012-6379
Practice Address - Country:US
Practice Address - Phone:425-481-1038
Practice Address - Fax:425-483-3158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00009254261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental