Provider Demographics
NPI:1023455540
Name:MILLENNIUM DENTAL CLINIC
Entity type:Organization
Organization Name:MILLENNIUM DENTAL CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:CAMRAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAFARNIA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:425-803-0400
Mailing Address - Street 1:1619 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-4963
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1619 MARKET ST
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-4963
Practice Address - Country:US
Practice Address - Phone:425-803-0400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-23
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty