Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122400000X | Denturist | DN0141 | WA |
NPI | 1407984727 |
---|---|
Provider Name | Mr. Efim Zukovski |
First Address | Bellevue, WA 98005 |
Second Address | Bellevue, WA 98005 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2007 |
Last Update Date | 08/07/2007 |