Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 60929248 | WA |
NPI | 1205394681 |
---|---|
Provider Name | Dana Buglione |
First Address | Seattle, WA 98195 |
Second Address | Seattle, WA 98195-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/03/2019 |
Last Update Date | 05/03/2019 |