North Lakewood Dental Plcc

NPI #1154617942 in Lakewood, Washington

Provider Information

NPI Number: 1154617942
Entity Type: Organization
Organization Name: North Lakewood Dental Plcc
Primary Specialty: Dentist
Enumeration Date: Jun 21, 2011
Last Updated: Jun 21, 2011

Practice Location

Address: 5422 74TH ST W
Address 2: SUITE B & C
City: Lakewood
State: Washington
ZIP Code: 98499-7900
Phone: (253) 475-9120

Authorized Official

Name: TRAVIS PROBST, D.D.S.
Title: DENTIST
Phone: (253) 475-9120

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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