Provider Demographics
NPI:1689480923
Name:KESANG NORBHU DMD PLLC
Entity type:Organization
Organization Name:KESANG NORBHU DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:N/A
Authorized Official - Prefix:
Authorized Official - First Name:N/A
Authorized Official - Middle Name:
Authorized Official - Last Name:N/A
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:000-000-0000
Mailing Address - Street 1:15101 NE 12TH WAY
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684-3688
Mailing Address - Country:US
Mailing Address - Phone:617-955-5226
Mailing Address - Fax:
Practice Address - Street 1:3405 NE 78TH ST
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98665-0657
Practice Address - Country:US
Practice Address - Phone:360-574-3061
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-10
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty