Individual
DR. MARK DAVID LAVIOLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1901 S UNION AVE, SUITE B-6001, TACOMA, WA 98405-1702
(253) 272-4041
(253) 627-7009
Mailing address
1901 S UNION AVE, SUITE B-6001, TACOMA, WA 98405-1702
(253) 272-4041
(253) 627-7009
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE00005591
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5016407
—
WA
Enumeration date
08/13/2006
Last updated
07/08/2007
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