# LOURDES M ACUESTA DDS PS

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

## Provider details

- **NPI number:** 1659480622
- **Authorized official:** DR. LOURDES MANCOL ACUESTA DDS (OWNER)
- **Authorized official phone:** (206) 322-7706

## Contact information

- **Practice address:** 1500 FAIRVIEW AVE E, SUITE 302, SEATTLE, WA 98102-3727
- **Practice address phone:** (206) 322-7706
- **Practice address fax:** (206) 329-5214
- **Mailing address:** 1500 FAIRVIEW AVE E, SUITE 302, SEATTLE, WA 98102-3727
- **Mailing address phone:** (206) 322-7706
- **Mailing address fax:** (206) 329-5214

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DE00005777 | WA | Yes |

## Other

- **Enumeration date:** 08/30/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 5000393 | — | WA |