Provider Demographics
NPI:1003210014
Name:STEVEN S. BROUGHTON, D.D.S. & ANGELA L. DUNN, D.D.S., P.L.L.C.
Entity Type:Organization
Organization Name:STEVEN S. BROUGHTON, D.D.S. & ANGELA L. DUNN, D.D.S., P.L.L.C.
Other - Org Name:LIGHT DENTAL STUDIOS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST & PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:253-848-2331
Mailing Address - Street 1:8012 112TH STREET CT E
Mailing Address - Street 2:SUITE #320
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98373-7856
Mailing Address - Country:US
Mailing Address - Phone:253-848-2331
Mailing Address - Fax:253-840-4033
Practice Address - Street 1:8012 112TH STREET CT E
Practice Address - Street 2:SUITE #320
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98373-7856
Practice Address - Country:US
Practice Address - Phone:253-848-2331
Practice Address - Fax:253-840-4033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-20
Last Update Date:2014-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60098994122300000X
WADE7977122300000X
WADE60096180122300000X
WADE60171760122300000X
WADE60223497122300000X
WADE60301791122300000X
WADE60365691122300000X
WADE60237858122300000X
WADE60387807122300000X
WADE8497122300000X
WADE60244633122300000X
WADE60485870122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty