NPI 1518406339

Summit Dental Lab

Organisation Dental Laboratory Port Orchard, WA

Practice location

Address: 1590 Woodridge Dr SE, Port Orchard, WA 98366-3818
Phone: (360) 871-2444
Mailing address: 4782 Rutherford Cir SW, Port Orchard, WA 98367-6430

Authorised official

Name: Allen Burleson
Title: Owner-Dental Lab
Phone: (360) 871-2444

Registered specialties

Dental Laboratory Primary

Laboratories Taxonomy 292200000X Licence 603128257 (WA)

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Registry record

NPI: 1518406339
Entity type: Organization
NPI issued: 13 Feb 2017
Record last updated: 13 Feb 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.