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1790203339
LEIF ROGER GERRITZEN
LACEY, WA
NPI
1790203339
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: WA DE60773945)
Enumeration Date
2017-09-04
Last Update Date
2017-09-04
Business Address
Dr. LEIF ROGER GERRITZEN DMD
669 WOODLAND SQUARE LOOP SE
LACEY, WA 98503-1038
Phone number: 360-359-4860
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Mailing Address
Dr. LEIF ROGER GERRITZEN DMD
PO BOX 34703
SEATTLE, WA 98124-1703
Phone number: 206-764-0502
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