Provider Demographics
NPI:1538422712
Name:ECKLAND PLLC
Entity type:Organization
Organization Name:ECKLAND PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:COLBY
Authorized Official - Middle Name:ADAM
Authorized Official - Last Name:ECKLAND
Authorized Official - Suffix:
Authorized Official - Credentials:DDS,
Authorized Official - Phone:425-481-0755
Mailing Address - Street 1:17330 135TH AVE NE
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-8522
Mailing Address - Country:US
Mailing Address - Phone:425-481-0755
Mailing Address - Fax:425-487-1578
Practice Address - Street 1:17330 135TH AVE NE
Practice Address - Street 2:SUITE 1A
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072-8522
Practice Address - Country:US
Practice Address - Phone:425-481-0755
Practice Address - Fax:425-487-1578
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-21
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty