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Organization
MOUNTLAKE FAMILY DENTISTRY
Active
Organization
MOUNTLAKE FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALYSHA MAES (OFFICE MANAGER)
(425) 412-3955
Entity
Organization
Contact information
Practice address
22725 44TH AVE W STE 100, MOUNTLAKE TERRACE, WA 98043-4583
(425) 412-3955
Mailing address
22725 44TH AVE W STE 100, MOUNTLAKE TERRACE, WA 98043-4583
(425) 412-3955
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
04/21/2020
Last updated
04/21/2020
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