Provider Demographics
NPI:1669717682
Name:MARC O. LANGLAND, DDS PLLC
Entity type:Organization
Organization Name:MARC O. LANGLAND, DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARC
Authorized Official - Middle Name:O
Authorized Official - Last Name:LANGLAND
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:206-463-9282
Mailing Address - Street 1:17425 VASHON HWY SW
Mailing Address - Street 2:
Mailing Address - City:VASHON
Mailing Address - State:WA
Mailing Address - Zip Code:98070-4653
Mailing Address - Country:US
Mailing Address - Phone:206-463-9282
Mailing Address - Fax:
Practice Address - Street 1:17425 VASHON HWY SW
Practice Address - Street 2:
Practice Address - City:VASHON
Practice Address - State:WA
Practice Address - Zip Code:98070-4653
Practice Address - Country:US
Practice Address - Phone:206-463-9282
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-02
Last Update Date:2012-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE601672861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty