| NPI | 1013381045 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLEKSANDR STASYUK Owner 425-346-1604 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WA DN60612122) |
| Enumeration Date | 2015-11-13 |
| Last Update Date | 2015-11-13 |