Provider Demographics
NPI:1023262623
Name:DR GARRICK J LO DDS PLLC
Entity type:Organization
Organization Name:DR GARRICK J LO DDS PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GARRICK
Authorized Official - Middle Name:J
Authorized Official - Last Name:LO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:206-851-8421
Mailing Address - Street 1:8435 161ST AVE NE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-1512
Mailing Address - Country:US
Mailing Address - Phone:425-885-1151
Mailing Address - Fax:425-883-0386
Practice Address - Street 1:8435 161ST AVE NE
Practice Address - Street 2:SUITE 102
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-1512
Practice Address - Country:US
Practice Address - Phone:425-885-1151
Practice Address - Fax:425-883-0386
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-10
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty