Provider Demographics
NPI:1043300197
Name:SHUR, LYUDMILA E (DDS)
Entity type:Individual
Prefix:DR
First Name:LYUDMILA
Middle Name:E
Last Name:SHUR
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 1:16108 ASH WAY
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98087-8779
Mailing Address - Country:US
Mailing Address - Phone:425-741-2030
Mailing Address - Fax:425-741-2026
Practice Address - Street 1:16108 ASH WAY
Practice Address - Street 2:SUITE 202
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98087-8779
Practice Address - Country:US
Practice Address - Phone:425-741-2030
Practice Address - Fax:425-741-2026
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00010297122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist