NPI | 1023323144 |
---|---|
Doing Business As | DISTINCTIVE DENTAL CARE |
Entity Type | Organization |
Authorized Contact | DANIEL E WILSON Member Of P LLC 360-892-1170 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA 00004959) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WA 00009284) |
Enumeration Date | 2010-08-12 |
Last Update Date | 2010-11-15 |