Provider Demographics
NPI:1295087328
Name:SOHN DDS PS
Entity type:Organization
Organization Name:SOHN DDS PS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SOHN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:206-745-0161
Mailing Address - Street 1:11524 15TH AVE NE STE A
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-6357
Mailing Address - Country:US
Mailing Address - Phone:206-367-3700
Mailing Address - Fax:
Practice Address - Street 1:11524 15TH AVE NE STE A
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-6357
Practice Address - Country:US
Practice Address - Phone:206-367-3700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-13
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty