Provider Demographics
NPI:1962197087
Name:SOPER ENTERPRISES-BURIEN II, PLLC
Entity type:Organization
Organization Name:SOPER ENTERPRISES-BURIEN II, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BARTON
Authorized Official - Middle Name:L
Authorized Official - Last Name:SOPER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS, PLLC
Authorized Official - Phone:425-747-9494
Mailing Address - Street 1:15105 5TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98166-3072
Mailing Address - Country:US
Mailing Address - Phone:206-210-5622
Mailing Address - Fax:206-210-5621
Practice Address - Street 1:15105 5TH AVE SW
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166-3072
Practice Address - Country:US
Practice Address - Phone:206-210-5622
Practice Address - Fax:206-210-5621
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADVANCED MANAGEMENT SERVICES COLLECTIVE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-04-05
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty