Individual
LYDIA WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1901 NE 162ND AVE STE D112, VANCOUVER, WA 98684-3008
(360) 726-6107
Mailing address
1901 NE 162ND AVE STE D112, VANCOUVER, WA 98684-3008
(901) 356-4616
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6075800
WA
Other
Enumeration date
06/26/2017
Last updated
06/26/2017
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