Provider Demographics
NPI:1619320173
Name:BARTON L SOPER
Entity Type:Organization
Organization Name:BARTON L SOPER
Other - Org Name:ADVANCED ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BARTON
Authorized Official - Middle Name:L
Authorized Official - Last Name:SOPER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MS PLLC
Authorized Official - Phone:425-747-9494
Mailing Address - Street 1:14575 BEL RED RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98007-3908
Mailing Address - Country:US
Mailing Address - Phone:425-747-9494
Mailing Address - Fax:425-747-9428
Practice Address - Street 1:14575 BEL RED RD
Practice Address - Street 2:SUITE 200
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-3908
Practice Address - Country:US
Practice Address - Phone:425-747-9494
Practice Address - Fax:425-747-9428
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-20
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA78071223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty