Provider Demographics
NPI:1528511235
Name:BELLEVUE ART DENTISTRY
Entity type:Organization
Organization Name:BELLEVUE ART DENTISTRY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NABIL
Authorized Official - Middle Name:
Authorized Official - Last Name:AL KRUMLY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:206-557-4522
Mailing Address - Street 1:11066 5TH AVE NE
Mailing Address - Street 2:100
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-6156
Mailing Address - Country:US
Mailing Address - Phone:206-557-4522
Mailing Address - Fax:206-557-4519
Practice Address - Street 1:11066 5TH AVE NE
Practice Address - Street 2:100
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-6156
Practice Address - Country:US
Practice Address - Phone:206-557-4522
Practice Address - Fax:206-557-4519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-28
Last Update Date:2016-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00009891261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental