Provider Demographics
NPI:1740738129
Name:HASAN DBOUK, BDS, MSD, PLLC
Entity Type:Organization
Organization Name:HASAN DBOUK, BDS, MSD, PLLC
Other - Org Name:SEATTLE DENTAL STUDIO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HASAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DBOUK
Authorized Official - Suffix:
Authorized Official - Credentials:BDS, MSD
Authorized Official - Phone:206-467-8302
Mailing Address - Street 1:600 UNIVERSITY ST STE 820
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-4117
Mailing Address - Country:US
Mailing Address - Phone:206-467-8302
Mailing Address - Fax:206-467-8304
Practice Address - Street 1:600 UNIVERSITY ST STE 820
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-4117
Practice Address - Country:US
Practice Address - Phone:206-467-8302
Practice Address - Fax:206-467-8304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-14
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental