Provider Demographics
NPI:1316083801
Name:FOLSOM, LUCINDA MARIA (DDS)
Entity type:Individual
Prefix:DR
First Name:LUCINDA
Middle Name:MARIA
Last Name:FOLSOM
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 WEST MAIN STREET
Mailing Address - Street 2:SUITE A
Mailing Address - City:MONROE
Mailing Address - State:WA
Mailing Address - Zip Code:98272-2172
Mailing Address - Country:US
Mailing Address - Phone:360-805-8448
Mailing Address - Fax:360-805-1099
Practice Address - Street 1:809 WEST MAIN STREET
Practice Address - Street 2:SUITE A
Practice Address - City:MONROE
Practice Address - State:WA
Practice Address - Zip Code:98272-2172
Practice Address - Country:US
Practice Address - Phone:360-805-8448
Practice Address - Fax:360-805-1099
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA5456122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist