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Individual

MRS. MEGAN ELISSA LICHTWARDT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
5122 OLYMPIC DRIVE SUITE B102, GIG HARBOR, WA 98335
(253) 851-1190
(253) 851-2183
Mailing address
5122 OLYMPIC DRIVE SUITE B102, GIG HARBOR, WA 98335
(253) 851-1190
(253) 851-2183

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE60819089
WA
1223G0001X
General Practice Dentistry
DS037479
PA

Other

Enumeration date
10/01/2008
Last updated
03/09/2021
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