Provider Demographics
NPI:1104372929
Name:CROSSPOINT DENTAL CENTER
Entity Type:Organization
Organization Name:CROSSPOINT DENTAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LUKE
Authorized Official - Middle Name:
Authorized Official - Last Name:DAINING
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:425-361-2856
Mailing Address - Street 1:19108 33RD AVENUE W #A
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036
Mailing Address - Country:US
Mailing Address - Phone:425-361-2856
Mailing Address - Fax:425-967-5137
Practice Address - Street 1:19108 33RD AVE W STE A
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-4728
Practice Address - Country:US
Practice Address - Phone:425-361-2856
Practice Address - Fax:425-967-5137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-31
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE603714081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty