Provider Demographics
NPI:1649754284
Name:LIZA MATHIAS DDS PLLC
Entity Type:Organization
Organization Name:LIZA MATHIAS DDS PLLC
Other - Org Name:UPTOWN DENTAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:F
Authorized Official - Last Name:TOEWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-385-4700
Mailing Address - Street 1:642 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:PORT TOWNSEND
Mailing Address - State:WA
Mailing Address - Zip Code:98368-6518
Mailing Address - Country:US
Mailing Address - Phone:360-385-4700
Mailing Address - Fax:360-379-9730
Practice Address - Street 1:642 HARRISON ST
Practice Address - Street 2:
Practice Address - City:PORT TOWNSEND
Practice Address - State:WA
Practice Address - Zip Code:98368-6518
Practice Address - Country:US
Practice Address - Phone:360-385-4700
Practice Address - Fax:360-379-9730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-19
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1518015163OtherSTEVEN J. SCHARF, DDS
WA1306368170OtherADRIAN R. OLSON, DDS