Provider Demographics
NPI:1033200555
Name:CHRISTINE LENTZ DDS AND LISA EGBERT DDS PS
Entity Type:Organization
Organization Name:CHRISTINE LENTZ DDS AND LISA EGBERT DDS PS
Other - Org Name:CREEKSIDE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP AND TREAS
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:EGBERT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:425-485-0300
Mailing Address - Street 1:19214 BOTHELL WAY NE
Mailing Address - Street 2:SUITE C
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011
Mailing Address - Country:US
Mailing Address - Phone:425-485-0300
Mailing Address - Fax:425-402-9186
Practice Address - Street 1:19214 BOTHELL WAY NE
Practice Address - Street 2:SUITE C
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011
Practice Address - Country:US
Practice Address - Phone:425-485-0300
Practice Address - Fax:425-402-9186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty