| Doctor Name: | JAVIER DIEGO DELGADO |
| NPI Number: | 1043476989 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LD |
| License Number: | |
| Business Practice Address: | 14400 Ambaum Blvd Sw Ste Q Burien, WA - 981661447 |
| Business Phone Number: | 2062440956 |
| Business Fax Number: | 2062441017 |
| Mailing Address: | 14400 Ambaum Blvd Sw Ste Q, BURIEN |
| State: | WA |
| Postal Code: | 981661447 |
| Phone Number: | 2062440956 |
| Fax Number: | 2062441017 |
| NPI Enumeration Date: | 07/30/2008 |
| NPI Last Update Date: | 07/30/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 122400000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Dental Providers |
| Taxonomy Classification: | Denturist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |