| NPI | 1609586932 |
|---|---|
| Doing Business As | SEA MAR CHC LAKEWOOD DENTAL |
| Entity Type | Organization |
| Authorized Contact | STEPHANIE LYN FOX Credentialing Supervisor 253-681-6603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2022-11-28 |
| Last Update Date | 2022-11-28 |