| NPI | 1043573603 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN A. RODGERS Managing Member 425-483-9000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WA DE 60149420) |
| Enumeration Date | 2012-06-19 |
| Last Update Date | 2012-06-19 |