Provider Demographics
NPI:1952637134
Name:ROSETO & NGUYEN, PLLC
Entity Type:Organization
Organization Name:ROSETO & NGUYEN, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:CARLSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-575-9150
Mailing Address - Street 1:15425 53RD AVE S
Mailing Address - Street 2:
Mailing Address - City:TUKWILA
Mailing Address - State:WA
Mailing Address - Zip Code:98188-2338
Mailing Address - Country:US
Mailing Address - Phone:206-575-9150
Mailing Address - Fax:206-575-9153
Practice Address - Street 1:15425 53RD AVE S
Practice Address - Street 2:
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98188-2338
Practice Address - Country:US
Practice Address - Phone:206-575-9150
Practice Address - Fax:206-575-9153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-23
Last Update Date:2009-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA107741223E0200X
WA63061223G0001X
WA584961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty