Provider Demographics
NPI:1275583957
Name:LABOUNTY, SUSAN DAWN (DDS)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:DAWN
Last Name:LABOUNTY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15613 BEL RED RD
Mailing Address - Street 2:BUILDING B. STE. C.
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98008-2348
Mailing Address - Country:US
Mailing Address - Phone:425-869-7560
Mailing Address - Fax:425-869-7699
Practice Address - Street 1:15613 BEL RED RD
Practice Address - Street 2:BUILDING B. STE. C.
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98008-2348
Practice Address - Country:US
Practice Address - Phone:425-869-7560
Practice Address - Fax:425-869-7699
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA64231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice