Provider Demographics
NPI:1801946736
Name:LAWTON, RODGER ALTON (DMD)
Entity type:Individual
Prefix:DR
First Name:RODGER
Middle Name:ALTON
Last Name:LAWTON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3425 ENSIGN RD NE
Mailing Address - Street 2:STE 210
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98506-5425
Mailing Address - Country:US
Mailing Address - Phone:360-459-4400
Mailing Address - Fax:360-459-4415
Practice Address - Street 1:3425 ENSIGN RD NE
Practice Address - Street 2:STE 210
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-5425
Practice Address - Country:US
Practice Address - Phone:360-459-4400
Practice Address - Fax:360-459-4415
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WA69401223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA6940OtherSTATE LICENSE NUMBER