Organization
SMILES 4 KIDS LACEY. PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MADISON LEHMAN (CREDENTIALING SPECIALIST)
(720) 603-4779
Entity
Organization
Contact information
Practice address
3315 PACIFIC AVENUE SE, SUITE A1, OLIMPIA, WA 98501
(360) 491-1414
Mailing address
3315 PACIFIC AVENUE SE, SUITE A1, OLIMPIA, WA 98501
(360) 491-1414
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE60282727
WA
Other
Enumeration date
01/17/2014
Last updated
07/06/2021
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