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General NPI Number Information
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NPI Number | 1932217247
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Entity Type | Individual
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Provider Name | CONSTANT E. LU DDS
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Gender | Male
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Dates
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Enumeration Date | 08/27/2006
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Last Update Date | 01/22/2014
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Provider Practice Location Address
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Address Line | 3205 NE 78TH ST
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City | VANCOUVER
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State | WA
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Zip | 98665-0697
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Country | US
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Telephone | 360-576-3570
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Fax |
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Provider Business Mailing Address
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Address Line | 400 N STONEGATE DR
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City | WASHOUGAL
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State | WA
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Zip | 98671-8587
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Country | US
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Telephone | 360-844-5616
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 7444
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License Number State | WA
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