Individual
SERGEY V LOZAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
875 140 AVE NE, #102, BELLEVUE, WA 98005
(425) 747-4445
(425) 747-1874
Mailing address
875 140 AVE NE, #102, BELLEVUE, WA 98005
(425) 747-4445
(425) 747-1874
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE00007563
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3287LO
REGENCE BLUE SHIELD
WA
05
—
5023684
—
WA
01
—
57563
WA DENTAL SERVICE
WA
Enumeration date
11/24/2006
Last updated
07/08/2007
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