Organization
TRACY L. DELORM, D.D.S. PLLC
Active
Other names
DeLorm Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY L. DELORM DDS (DOCTOR)
(425) 334-4001
Entity
Organization
Contact information
Practice address
9514 4TH ST. NE UNIT 102, LAKE STEVENS, WA 98258
(425) 334-4001
(425) 335-4003
Mailing address
9514 4TH ST NE UNIT 102, LAKE STEVENS, WA 98258-1937
(425) 334-4001
(425) 335-4003
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE9086
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
501627465
—
WA
Enumeration date
09/01/2016
Last updated
09/01/2016
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