Provider Demographics
NPI:1629314950
Name:MICHAELA BOBEVA DDS MSD PLLC
Entity Type:Organization
Organization Name:MICHAELA BOBEVA DDS MSD PLLC
Other - Org Name:BELLEVUE HARMONY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAELA
Authorized Official - Middle Name:VENTZISLAVOVA
Authorized Official - Last Name:BOBEVA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MSD
Authorized Official - Phone:425-747-0144
Mailing Address - Street 1:15419 NE 20TH ST STE 101
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98007-3838
Mailing Address - Country:US
Mailing Address - Phone:425-747-0144
Mailing Address - Fax:425-747-1413
Practice Address - Street 1:15419 NE 20TH ST STE 101
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-3838
Practice Address - Country:US
Practice Address - Phone:425-747-0144
Practice Address - Fax:425-747-1413
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-13
Last Update Date:2012-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00009991261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental