Individual
DR. STIG K A OSTERBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS MSD
Contact information
Practice address
1119 LAWRENCE ST, PT TOWNSEND, WA 98368-6525
(360) 385-5121
(360) 379-9534
Mailing address
1119 LAWRENCE ST, PT TOWNSEND, WA 98368-6525
(360) 385-5121
(360) 379-9534
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DE00005095
WA
1223P0300X
Periodontics
Primary
DE00005095
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0156577
L AND I
—
01
—
662902093
ACA
—
Enumeration date
09/13/2005
Last updated
09/09/2010
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