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Organization
SOUTH LAKE FAMILY DENTISTRY
Active
Organization
SOUTH LAKE FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TODD MIESEL DDS (OWNER)
(425) 334-9600
Entity
Organization
Contact information
Practice address
10515 20TH ST SE, SUITE 201, LAKE STEVENS, WA 98258-4764
(425) 334-9600
(425) 334-9900
Mailing address
10515 20TH ST SE, SUITE 201, LAKE STEVENS, WA 98258-4764
(425) 334-9600
(425) 334-9900
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7981
WA
Other
Enumeration date
08/12/2014
Last updated
08/12/2014
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