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9421 N. Davies Road #a Lake Stevens WA 98258 | |
| (425) 367-4149 | |
| (425) 609-4530 |
| Full Name | |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 9421 N. Davies Road #a, Lake Stevens, Washington |
| Authorized Official Name and Position | Jessica R Knight (ACCOUNT RECEIVABLE MANAGER) |
| Authorized Official Contact | 4253674149 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
9421 N. Davies Road #a Lake Stevens WA 98258 Ph: (425) 367-4149 | 9421 N. Davies Road #a Lake Stevens WA 98258 Ph: (425) 367-4149 |
| NPI Number | 1154675064 |
|---|---|
| Provider Enumeration Date | 10/30/2012 |
| Last Update Date | 04/11/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154675064 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | DE00009918 (Washington) | Primary |
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Secondary |
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Lakeview Dental Clinic Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 9421 N Davies Rd, Lake Stevens, WA 98258 Phone: 425-334-2900 Fax: 425-334-6958 | |
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