# LAVERN H. SWENSON DDS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639358021
- **Authorized official:** DR. LAVERN HENRY SWENSON DDS (DENTIST OWNER)
- **Authorized official phone:** (360) 452-4615

## Contact information

- **Practice address:** 618 S PEABODY ST, SUITE A, PORT ANGELES, WA 98362-6244
- **Practice address phone:** (360) 452-4615
- **Practice address fax:** (360) 452-0764
- **Mailing address:** 618 S PEABODY ST, SUITE A, PORT ANGELES, WA 98362-6244
- **Mailing address phone:** (360) 452-4615
- **Mailing address fax:** (360) 452-0764

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | DE00004802 | WA | Yes |

## Other

- **Enumeration date:** 11/01/2007
- **Last updated:** 11/01/2007