Provider Demographics
NPI:1487318986
Name:MYLA ALDER DMD PLLC
Entity type:Organization
Organization Name:MYLA ALDER DMD PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LYUDMYLA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALDER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:425-823-8100
Mailing Address - Street 1:1722 185TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98290-4446
Mailing Address - Country:US
Mailing Address - Phone:425-330-1553
Mailing Address - Fax:
Practice Address - Street 1:9750 NE 120TH PL STE 4
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-4207
Practice Address - Country:US
Practice Address - Phone:425-823-8100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-29
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental