| NPI | 1003269473 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BYRON S. MIZUHA Periodontist 425-771-3000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 125K00000X Advanced Practice Dental Therapist (Licence: WA 4650) |
| Enumeration Date | 2016-07-20 |
| Last Update Date | 2016-07-20 |