Provider Demographics
NPI:1669692141
Name:MICHELLE M DOTSCH, DDS, PS
Entity type:Organization
Organization Name:MICHELLE M DOTSCH, DDS, PS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:M
Authorized Official - Last Name:DOTSCH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:206-542-4344
Mailing Address - Street 1:17900 LINDEN AVE N
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-4824
Mailing Address - Country:US
Mailing Address - Phone:206-542-4344
Mailing Address - Fax:206-542-7673
Practice Address - Street 1:17900 LINDEN AVE N
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98133-4824
Practice Address - Country:US
Practice Address - Phone:206-542-4344
Practice Address - Fax:206-542-7673
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000072611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty