NPI | 1013564384 |
---|---|
Doing Business As | HAMPDEN DENTAL GROUP |
Entity Type | Organization |
Authorized Contact | MICHELLE JOHNSON Credentialing Specialist 509-315-8338 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2019-08-21 |
Last Update Date | 2019-08-21 |