Provider Demographics
NPI:1073682068
Name:MARTIN LOTZKAR DDS PS
Entity Type:Organization
Organization Name:MARTIN LOTZKAR DDS PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LOTZKAR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:425-454-7819
Mailing Address - Street 1:1199 116TH AVE NE
Mailing Address - Street 2:#4
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004
Mailing Address - Country:US
Mailing Address - Phone:425-454-7819
Mailing Address - Fax:425-454-9412
Practice Address - Street 1:1199 116TH AVE NE
Practice Address - Street 2:#4
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004
Practice Address - Country:US
Practice Address - Phone:425-454-7819
Practice Address - Fax:425-454-9412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA2956122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty