Individual
DR. LEIF ROGER GERRITZEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
669 WOODLAND SQUARE LOOP SE, LACEY, WA 98503-1038
(360) 359-4860
Mailing address
PO BOX 34703, SEATTLE, WA 98124-1703
(206) 764-0502
(206) 764-0516
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE60773945
WA
Other
Enumeration date
09/04/2017
Last updated
09/04/2017
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