Provider Demographics
NPI:1801031653
Name:ANTHONY T. LOVROVICH, DDS, PS
Entity Type:Organization
Organization Name:ANTHONY T. LOVROVICH, DDS, PS
Other - Org Name:NORTHWEST CENTER FOR ORTHODONTICS & FACIAL ORTHOPEDICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:T
Authorized Official - Last Name:LOVROVICH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:206-525-7000
Mailing Address - Street 1:4540 SANDPOINT WAY NE
Mailing Address - Street 2:SUITE 140
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105
Mailing Address - Country:US
Mailing Address - Phone:206-525-7000
Mailing Address - Fax:206-525-0479
Practice Address - Street 1:4540 SANDPOINT WAY NE
Practice Address - Street 2:SUITE 140
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105
Practice Address - Country:US
Practice Address - Phone:206-525-7000
Practice Address - Fax:206-525-0479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-09
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA5590122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5019450Medicaid
WA7980OtherDEPT. OF HEALTH