Unknown Individual – Dentist, NPI 1104830603
Dentist
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
Lacey Spring Post Office, 8975, North Valley Pike, Lacey Spring, Rockingham County, Virginia, 22833, United States
LACEY, WA 98509
Phone: (360) 491-9666
Fax: (360) 459-7675
Type: Mailing
7046, Pacific Avenue Southeast, Olympia, Thurston County, Washington, 98503, United States
OLYMPIA, WA 98503
Phone: (360) 491-9666
Fax: (360) 459-7675
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 98509)
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