| Delorm Family Dental | |
|
9514 4th St. Ne Unit 102 Lake Stevens WA 98258 | |
| (425) 334-4001 | |
| (425) 335-4003 |
| Full Name | Delorm Family Dental |
|---|---|
| Speciality | Dentist |
| Location | 9514 4th St. Ne Unit 102, Lake Stevens, Washington |
| Authorized Official Name and Position | Tracy L. Delorm (DOCTOR) |
| Authorized Official Contact | 4253344001 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Delorm Family Dental 9514 4th St Ne Unit 102 Lake Stevens WA 98258-1937 Ph: (425) 334-4001 | Delorm Family Dental 9514 4th St. Ne Unit 102 Lake Stevens WA 98258 Ph: (425) 334-4001 |
| NPI Number | 1881140499 |
|---|---|
| Provider Enumeration Date | 09/01/2016 |
| Last Update Date | 09/01/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881140499 | NPI | - | NPPES |
| 501627465 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DE9086 (Washington) | Primary |
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