| NPI | 1023123726 |
|---|---|
| Other Name | PACIFIC AVENUE DENTAL |
| Entity Type | Organization |
| Authorized Contact | ALLAN LEE HABLUTZEL Dentist Owner 360-373-3515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: WA 5706) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2012-05-08 |