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Organization

LAWRENCE E. MAST DDS

Active
Parent organization
LAWRENCE E. MAST DDS
Other names
Snoqualmie Valley Kids Dentist
Organization subpart
Yes

Provider details

NPI number
Legal business name
LAWRENCE E. MAST DDS
Authorized official
MRS. LANETTE MCINTOSH (BUSINESS MANAGER)
(425) 455-0784
Entity
Organization

Contact information

Practice address
34929 SE RIDGE ST STE 220, SNOQUALMIE, WA 98065-6306
(425) 396-1011
(425) 396-1258
Mailing address
34929 SE RIDGE ST STE 220, SNOQUALMIE, WA 98065-6306
(425) 396-1011
(425) 396-1258

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
4233
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5018171
WA
05
5052956
WA
Enumeration date
10/28/2008
Last updated
11/17/2008
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