Organization
LILLY DENTURE CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PATRICK M CARBONE D.P.D. (DENTURIST)
(360) 412-0812
Entity
Organization
Contact information
Practice address
200 LILLY RD NE STE A, OLYMPIA, WA 98506-5080
(360) 412-0812
(360) 412-0814
Mailing address
200 LILLY RD NE STE A, OLYMPIA, WA 98506-5080
(360) 412-0812
(360) 412-0814
Taxonomy
Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
DN00000194
WA
Other
Enumeration date
12/04/2006
Last updated
08/22/2020
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