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Individual

LAURA BURGETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
17224 SE 272ND ST, COVINGTON, WA 98042-4953
(253) 630-4400
Mailing address
708 E 3RD ST, COAL VALLEY, IL 61240-9413

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE60761963
WA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
05/24/2016
Last updated
09/27/2023
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