Provider Demographics
NPI:1750492989
Name:LUGO, CHRISTOPHER GEORGE (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:GEORGE
Last Name:LUGO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:919 STATE AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98270-4284
Mailing Address - Country:US
Mailing Address - Phone:206-992-4420
Mailing Address - Fax:360-659-8133
Practice Address - Street 1:919 STATE AVE STE 104
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98270-4284
Practice Address - Country:US
Practice Address - Phone:360-659-8100
Practice Address - Fax:360-659-8133
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX389091223P0221X
WA0000099181223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry