Provider Demographics
NPI:1619190147
Name:MICHAEL E MCDADE DDS
Entity Type:Organization
Organization Name:MICHAEL E MCDADE DDS
Other - Org Name:MICHAEL E MCDADE DDS
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:MCDADE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:425-486-9211
Mailing Address - Street 1:6507 NE 181ST ST
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:WA
Mailing Address - Zip Code:98028-4801
Mailing Address - Country:US
Mailing Address - Phone:425-486-9211
Mailing Address - Fax:425-402-1093
Practice Address - Street 1:6507 NE 181ST ST
Practice Address - Street 2:
Practice Address - City:KENMORE
Practice Address - State:WA
Practice Address - Zip Code:98028-4801
Practice Address - Country:US
Practice Address - Phone:425-486-9211
Practice Address - Fax:425-402-1093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00006051122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty