Organization
WASHINGTON DENTAL CORPORATION PC
Active
Other names
Lake Stevens Modern Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DULCE GOMEZ (CREDENTIALING COORDINATOR)
(714) 845-8701
Entity
Organization
Contact information
Practice address
907 FRONTIER CIRCLE E, SUITE 110, LAKE STEVENS, WA 98258
(425) 697-9219
(425) 697-9228
Mailing address
17000 RED HILL AVE, IRVINE, CA 92614-5626
(714) 845-8500
(303) 952-0892
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
03/08/2018
Last updated
03/08/2018
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