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General NPI Number Information
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NPI Number | 1023262623
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Entity Type | Organization
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Legal Business Name | DR GARRICK J LO DDS PLLC
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Dates
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Enumeration Date | 11/10/2008
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Last Update Date | 09/27/2023
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Provider Practice Location Address
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Address Line | 8435 161ST AVE NE SUITE 102
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City | REDMOND
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State | WA
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Zip | 98052-1512
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Country | US
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Telephone | 425-885-1151
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Fax | 425-883-0386
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Provider Business Mailing Address
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Address Line | 8435 161ST AVE NE SUITE 102
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City | REDMOND
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State | WA
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Zip | 98052-1512
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Country | US
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Telephone | 425-885-1151
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Fax | 425-883-0386
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Authorized Official
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Title or Position | OWNER
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Name | DR. GARRICK J LO
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Credential | DDS
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Telephone | 206-851-8421
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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