Provider Demographics
NPI:1841619061
Name:RODGER A. LAWTON, DMD, PS
Entity Type:Organization
Organization Name:RODGER A. LAWTON, DMD, PS
Other - Org Name:NORTHWEST CENTER FOR PROSTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RODGER
Authorized Official - Middle Name:A
Authorized Official - Last Name:LAWTON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:360-459-4400
Mailing Address - Street 1:3425 ENSIGN RD NE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98506-5425
Mailing Address - Country:US
Mailing Address - Phone:360-459-4400
Mailing Address - Fax:
Practice Address - Street 1:3425 ENSIGN RD NE
Practice Address - Street 2:SUITE 210
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-5425
Practice Address - Country:US
Practice Address - Phone:360-459-4400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-15
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA601439738261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental