Provider Demographics
NPI:1255790861
Name:LAKEVIEW DENTAL CLINIC
Entity type:Organization
Organization Name:LAKEVIEW DENTAL CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHUNG
Authorized Official - Middle Name:HAO
Authorized Official - Last Name:TSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:425-334-2900
Mailing Address - Street 1:9421 N DAVIES RD
Mailing Address - Street 2:
Mailing Address - City:LAKE STEVENS
Mailing Address - State:WA
Mailing Address - Zip Code:98258-9444
Mailing Address - Country:US
Mailing Address - Phone:425-334-2900
Mailing Address - Fax:425-334-6958
Practice Address - Street 1:9421 N DAVIES RD
Practice Address - Street 2:
Practice Address - City:LAKE STEVENS
Practice Address - State:WA
Practice Address - Zip Code:98258-9444
Practice Address - Country:US
Practice Address - Phone:425-334-2900
Practice Address - Fax:425-334-6958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-11
Last Update Date:2016-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental