Organization
L DOUGLAS GRAY DDS AND KENNETH K LO DDS PS
Active
Other names
Roosevelt Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LLOYD DOUGLAS GRAY DDS (OWNER)
(206) 524-6100
Entity
Organization
Contact information
Practice address
6417 ROOSEVELT WAY NE, #206, SEATTLE, WA 98115
(206) 524-6100
(206) 522-4608
Mailing address
6417 ROOSEVELT WAY NE, #206, SEATTLE, WA 98115
(206) 524-6100
(206) 522-4608
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
114742
L AND I
WA
Enumeration date
04/27/2007
Last updated
08/22/2020
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