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MAHADEEP VIRK DMD MSD & ELLEN POLSKY DDS, PLLC

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Company Details

Legal Name: MAHADEEP VIRK DMD MSD & ELLEN POLSKY DDS, PLLC
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Active
Formation/ Registration Date: November 7th 2024
Expiration date: 30 Nov 2025
UBI Number: 605 635 860
ZIP code: 98188
City: Seattle
County: KING
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 505 STRANDER BLVD, TUKWILA, WA, 98188-2920, UNITED STATES

Contact Details

E-Mail: LAUREN@BROCKLF.COM
Phone Number: +1 509-622-4707

Nature of Business

Other Services

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Registered Agent Information

Name Role Address
COREY F BROCK Registered Agent 111 S POST ST STE 2280, SPOKANE, WA, 99201-4900, UNITED STATES

Key Officers & Management

Name Role Address
MAHADEEP VIRK Governing Person -
ELLEN POLSKY Governing Person -
MAHADEEP VIRK EXECUTOR 505 STRANDER BLVD, TUKWILA, WA, 98188-2920, UNITED STATES

National Provider Identifier

NPI Number:
1699590174
Certification Date:
2024-11-19

Authorized Person:

Name:
ANGIE METZGER
Role:
BILLING MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
1223X0400X - Orthodontics and Dentofacial Orthopedic Dentist
Is Primary:
No
Selected Taxonomy:
1223P0221X - Pediatric Dentist
Is Primary:
Yes

Contacts:

Fax:
2536044130
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