| NPI | 1033594346 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID ANGOTTI Finance Director 509-823-4480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA DE00009229) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WA DE60220488) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WA DE60477207) | |
| Enumeration Date | 2015-07-28 |
| Last Update Date | 2015-07-28 |