Fairwood Dental LLC
NPI #1639799471 in Renton, Washington
Provider Information
- NPI Number
- 1639799471
- Entity Type
- Organization
- Organization Name
- Fairwood Dental LLC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Apr 22, 2020
- Last Updated
- Apr 22, 2020
Practice Location
- Address
- 14250 SE 176TH #J7
- City
- Renton
- State
- Washington
- ZIP Code
- 98058
- Phone
- (253) 631-3015
Authorized Official
- Name
- TRAVIS PROBST, DDS
- Title
- OWNER
- Phone
- (253) 631-3015
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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