Lavince Group Ps

NPI #1043591043 in Yelm, Washington

Provider Information

NPI Number: 1043591043
Entity Type: Organization
Organization Name: Lavince Group Ps
Primary Specialty: Clinic/Center - Dental
Enumeration Date: Sep 2, 2011
Last Updated: Sep 25, 2011

Practice Location

Address: 202 FIRST STREET SOUTH,
City: Yelm
State: Washington
ZIP Code: 98597
Phone: (360) 458-7645

Authorized Official

Name: JAMES VINCENT SHUCK
Title: VP
Phone: (360) 458-7645

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Dental — Dental	261QD0000X	Primary

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