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Organization
TRACY L. DELORM, D.D.S. PLLC
Active
Organization
TRACY L. DELORM, D.D.S. PLLC
Active
Other names
DeLorm Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY L. DELORM DDS (DOCTOR)
(425) 334-4001
Entity
Organization
Contact information
Practice address
9514 4TH ST. NE UNIT 102, LAKE STEVENS, WA 98258
(425) 334-4001
(425) 335-4003
Mailing address
9514 4TH ST NE UNIT 102, LAKE STEVENS, WA 98258-1937
(425) 334-4001
(425) 335-4003
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE9086
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
501627465
—
WA
Enumeration date
09/01/2016
Last updated
09/01/2016
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