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PHAT LY, DMD, PLLC.

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Company Details

Legal Name: PHAT LY, DMD, PLLC.
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Active
Formation/ Registration Date: November 24th 2021
Expiration date: 30 Nov 2025
UBI Number: 604 837 631
ZIP code: 98642
City: Ridgefield
County: CLARK
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 8507 S 5TH ST STE A-101, RIDGEFIELD, WA, 98642-3421, UNITED STATES
Principal Office Mailing Address: Google Maps Logo 17617 NE 95TH AVE, BATTLE GROUND, WA, 98604-6173, UNITED STATES

Contact Details

E-Mail: LYT8211@YAHOO.COM
Phone Number: +1 360-713-7760

Nature of Business

Other Services, DENTAL SERVICES

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Registered Agent Information

Name Role Address
THANH LY Registered Agent 8507 S 5TH ST STE A-101, RIDGEFIELD, WA, 98642-3421, UNITED STATES

Key Officers & Management

Name Role Address
PHAT LY Executor 17617 NE 95TH AVE, BATTLE GROUND, WA, 98604-6173, UNITED STATES
PHAT LY Governing Person -

National Provider Identifier

NPI Number:
1841958626
Certification Date:
2021-11-29

Authorized Person:

Name:
DR. PHAT LY
Role:
DENTIST
Phone:

Taxonomy:

Selected Taxonomy:
122300000X - Dentist
Is Primary:
Yes

Contacts:

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