Provider Demographics
NPI:1215224498
Name:COVINGTON COMFORT DENTISTRY
Entity type:Organization
Organization Name:COVINGTON COMFORT DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:BAPTISTA
Authorized Official - Middle Name:
Authorized Official - Last Name:KWOK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:425-837-0711
Mailing Address - Street 1:17265 SE WAX RD
Mailing Address - Street 2:STE # 101
Mailing Address - City:COVINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98042-9124
Mailing Address - Country:US
Mailing Address - Phone:253-639-6868
Mailing Address - Fax:
Practice Address - Street 1:22525 SE 64TH PL
Practice Address - Street 2:STE #170
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-5383
Practice Address - Country:US
Practice Address - Phone:425-837-0711
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-07
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000087011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty