| Lake Stevens Modern Dentistry | |
|
907 Frontier Circle E Suite 110 Lake Stevens WA 98258 | |
| (425) 697-9219 | |
| (425) 697-9228 |
| Full Name | Lake Stevens Modern Dentistry |
|---|---|
| Speciality | Dentist |
| Location | 907 Frontier Circle E, Lake Stevens, Washington |
| Authorized Official Name and Position | Dulce Gomez (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 7148458701 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Stevens Modern Dentistry 17000 Red Hill Ave Irvine CA 92614-5626 Ph: (714) 845-8500 | Lake Stevens Modern Dentistry 907 Frontier Circle E Suite 110 Lake Stevens WA 98258 Ph: (425) 697-9219 |
| NPI Number | 1811490550 |
|---|---|
| Provider Enumeration Date | 03/08/2018 |
| Last Update Date | 03/08/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811490550 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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