Organization
PSPD - MARYSVILLE, PLLC
Active
Parent organization
LUGO DMD MARYSVILLE PS
Other names
Puget Sound Pediatric Dentistry
Organization subpart
Yes
Provider details
NPI number
Legal business name
LUGO DMD MARYSVILLE PS
Authorized official
JESSICA R KNIGHT (ACCOUNT RECEIVABLES MANAGER)
(360) 659-8100
Entity
Organization
Contact information
Practice address
919 STATE AVE STE 104, MARYSVILLE, WA 98270-4284
(360) 659-8100
(360) 659-8133
Mailing address
919 STATE AVE STE 104, MARYSVILLE, WA 98270-4284
(360) 659-8100
(360) 659-8133
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
WA
Other
Enumeration date
08/01/2011
Last updated
04/11/2022
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