| NPI | 1033696331 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS HARKER Manager 509-302-1321 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: WA DE60361349) |
| Enumeration Date | 2018-07-19 |
| Last Update Date | 2018-07-19 |