Provider Demographics
NPI:1780667659
Name:LANCASTER, PETER J (DDS)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:J
Last Name:LANCASTER
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 1:403 E MEEKER ST
Mailing Address - Street 2:STE 300
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98030-5904
Mailing Address - Country:US
Mailing Address - Phone:253-372-3641
Mailing Address - Fax:425-277-1566
Practice Address - Street 1:16345 NE 87TH ST
Practice Address - Street 2:STE C2
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3503
Practice Address - Country:US
Practice Address - Phone:425-883-8000
Practice Address - Fax:425-883-7580
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WADE000100681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice