Provider Demographics
NPI:1659460111
Name:LOTZKAR, MARTIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:
Last Name:LOTZKAR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1199 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
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA2956122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist