Organization
PSPD - LAKE STEVENS PLLC
Active
Parent organization
LUGO DMD MARYSVILLE PS
Other names
Puget Sound Pediatric Dentistry
Organization subpart
Yes
Provider details
NPI number
Legal business name
LUGO DMD MARYSVILLE PS
Authorized official
MRS. JESSICA R KNIGHT (ACCOUNT RECEIVABLE MANAGER)
(425) 367-4149
Entity
Organization
Contact information
Practice address
9421 N. DAVIES ROAD #A, LAKE STEVENS, WA 98258
(425) 367-4149
(425) 609-4530
Mailing address
9421 N. DAVIES ROAD #A, LAKE STEVENS, WA 98258
(425) 367-4149
(425) 609-4530
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DE00009918
WA
1223P0221X
Pediatric Dentistry
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Other
Enumeration date
10/30/2012
Last updated
04/11/2022
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