Individual
JONATHAN MYLES LARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3910 MARTIN WAY E STE A, OLYMPIA, WA 98506-5220
(360) 459-1333
Mailing address
8012 112TH STREET CT E STE 320, PUYALLUP, WA 98373-7856
(253) 848-2331
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
70022845
WA
Other
Enumeration date
08/01/2025
Last updated
08/01/2025
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