Organization
LOURDES M ACUESTA DDS PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LOURDES MANCOL ACUESTA DDS (OWNER)
(206) 322-7706
Entity
Organization
Contact information
Practice address
1500 FAIRVIEW AVE E, SUITE 302, SEATTLE, WA 98102-3727
(206) 322-7706
(206) 329-5214
Mailing address
1500 FAIRVIEW AVE E, SUITE 302, SEATTLE, WA 98102-3727
(206) 322-7706
(206) 329-5214
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE00005777
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5000393
—
WA
Enumeration date
08/30/2006
Last updated
08/22/2020
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