Provider Demographics
NPI:1760919716
Name:QUIL CEDA HAPPY DENTAL, INC
Entity Type:Organization
Organization Name:QUIL CEDA HAPPY DENTAL, INC
Other - Org Name:QUIL CEDA HAPPY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:SHIH-YIN
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:206-229-5880
Mailing Address - Street 1:13003 SE KENT KANGLEY RD STE 109
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98030-7919
Mailing Address - Country:US
Mailing Address - Phone:253-630-8686
Mailing Address - Fax:253-630-0188
Practice Address - Street 1:8825 34TH AVE NE STE M
Practice Address - Street 2:
Practice Address - City:QUIL CEDA VILLAGE
Practice Address - State:WA
Practice Address - Zip Code:98271-8085
Practice Address - Country:US
Practice Address - Phone:360-659-1149
Practice Address - Fax:360-716-3626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-20
Last Update Date:2017-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE90771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty