Provider Demographics
NPI:1659737245
Name:PAUL F. GENUNG D.D.S. INC.
Entity Type:Organization
Organization Name:PAUL F. GENUNG D.D.S. INC.
Other - Org Name:HEALTH-CONSCIOUS DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:F
Authorized Official - Last Name:GENUNG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:206-623-4674
Mailing Address - Street 1:1904 3RD AVE STE 1031
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-1199
Mailing Address - Country:US
Mailing Address - Phone:206-623-4674
Mailing Address - Fax:
Practice Address - Street 1:1904 3RD AVE STE 1031
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-1199
Practice Address - Country:US
Practice Address - Phone:206-623-4674
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-12
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA3370302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization