Individual
LUCAS ROBERT BEATTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.D.
Contact information
Practice address
15515 3RD AVE SW, SUITE E, BURIEN, WA 98166-2553
(206) 248-3035
Mailing address
15515 3RD AVE SW, SUITE E, BURIEN, WA 98166-2553
(206) 248-3035
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
D7255
AZ
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DE60172592
WA
Other
Enumeration date
05/21/2007
Last updated
12/20/2010
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