Organization
LAKE MERIDIAN DENTAL LLC
Active
Other names
Comfort Dental Lake Meridian
Organization subpart
No
Provider details
NPI number
Authorized official
TRAVIS JOHN PROBST DDS (DENTIST)
(253) 631-3015
Entity
Organization
Contact information
Practice address
12906 SE KENT KANGLEY RD, KENT, WA 98030-7940
(253) 631-3015
Mailing address
12906 SE KENT KANGLEY RD, KENT, WA 98030-7940
(253) 631-3015
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE60198294
WA
Other
Enumeration date
10/30/2014
Last updated
10/30/2014
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