Fred Ebsworth DDS Ps
NPI #1104061969 in Lake Forest Park, Washington
Provider Information
- NPI Number
- 1104061969
- Entity Type
- Organization
- Organization Name
- Fred Ebsworth DDS Ps
- Primary Specialty
- Clinic/Center - Dental
- Enumeration Date
- Dec 9, 2008
- Last Updated
- Dec 9, 2008
Practice Location
- Address
- 17191 BOTHELL WAY NE
- Address 2
- SUITE 201
- City
- Lake Forest Park
- State
- Washington
- ZIP Code
- 98155-5534
- Phone
- (206) 362-0152
Authorized Official
- Name
- DR. CHARLES F EBSWORTH, DDS
- Title
- PRESIDENT
- Phone
- (206) 362-0152
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Dental — Dental |
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