# MARTHA LAKE DENTAL CENTER

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

## Provider details

- **NPI number:** 1649475799
- **Authorized official:** DR. ANDREW T TRAN DDS (PRESIDENT)
- **Authorized official phone:** (425) 787-2402

## Contact information

- **Practice address:** 1233 164TH ST SW, STE \#H, LYNNWOOD, WA 98087
- **Practice address phone:** (425) 787-2402
- **Practice address fax:** (425) 787-5350
- **Mailing address:** 1233 164TH ST SW, STE \#H, LYNNWOOD, WA 98087
- **Mailing address phone:** (425) 787-2402
- **Mailing address fax:** (425) 787-5350

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | DE9941 | WA | Yes |

## Other

- **Enumeration date:** 06/19/2007
- **Last updated:** 08/22/2020