NPI | 1013153469 |
---|---|
Doing Business As | CLEARWATER DENTAL |
Entity Type | Organization |
Authorized Contact | STEPHEN RICHARD MATHESON CEO 509-783-5000 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE00004645) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WA DE00008483) |
1223G0001X Dentist, General Practice (Licence: WA DE00010578) | |
Enumeration Date | 2009-01-06 |
Last Update Date | 2014-07-11 |