Provider Demographics
NPI:1417305376
Name:STEVEN C LOCKETT DMD
Entity Type:Organization
Organization Name:STEVEN C LOCKETT DMD
Other - Org Name:COMPREHENSIVE DENTAL
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:OONA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-226-2348
Mailing Address - Street 1:14300 SE PETROVITSKY RD
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98058-8955
Mailing Address - Country:US
Mailing Address - Phone:425-226-2348
Mailing Address - Fax:425-226-2392
Practice Address - Street 1:14300 SE PETROVITSKY RD
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98058-8955
Practice Address - Country:US
Practice Address - Phone:425-226-2348
Practice Address - Fax:425-226-2392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-01
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA55891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty