| NPI | 1013229954 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TEJASVI SIDHU Dentist 206-618-3482 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE60133154) |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2010-07-08 |