South Lake Family Dentistry
NPI #1275942518 in Lake Stevens, Washington
Provider Information
- NPI Number
- 1275942518
- Entity Type
- Organization
- Organization Name
- South Lake Family Dentistry
- Primary Specialty
- Dentist
- Enumeration Date
- Aug 12, 2014
- Last Updated
- Aug 12, 2014
Practice Location
- Address
- 10515 20TH ST SE
- Address 2
- SUITE 201
- City
- Lake Stevens
- State
- Washington
- ZIP Code
- 98258-4764
- Phone
- (425) 334-9600
Authorized Official
- Name
- DR. TODD MIESEL, DDS
- Title
- OWNER
- Phone
- (425) 334-9600
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist |
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