Provider Demographics
NPI:1679899637
Name:J. MICHAEL EARLY DDS
Entity type:Organization
Organization Name:J. MICHAEL EARLY DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DDS
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:EARLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-641-3311
Mailing Address - Street 1:14535 BEL RED RD STE 100
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98007-3907
Mailing Address - Country:US
Mailing Address - Phone:425-641-3311
Mailing Address - Fax:425-641-8185
Practice Address - Street 1:14535 BEL RED RD STE 100
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-3907
Practice Address - Country:US
Practice Address - Phone:425-641-3311
Practice Address - Fax:425-641-8185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-15
Last Update Date:2010-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA6140261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental