Provider Demographics
NPI:1710096375
Name:DALLMAN, JON A (DDS)
Entity Type:Individual
Prefix:
First Name:JON
Middle Name:A
Last Name:DALLMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:18321 98TH AVE NE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011-3391
Mailing Address - Country:US
Mailing Address - Phone:425-486-6300
Mailing Address - Fax:425-487-6498
Practice Address - Street 1:18321 98TH AVE NE
Practice Address - Street 2:SUITE 2
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-3391
Practice Address - Country:US
Practice Address - Phone:425-486-6300
Practice Address - Fax:425-487-6498
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WA78371223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry