| NPI | 1003122789 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADFORD LOEFFLER FRANK Owner/Manager 360-280-4343 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D8410) |
| Enumeration Date | 2010-08-19 |
| Last Update Date | 2010-08-19 |