| NPI | 1053143073 |
|---|---|
| Doing Business As | COWLITZ RIVER DENTAL |
| Entity Type | Organization |
| Authorized Contact | LILY CROCCO Owner Dentist 760-750-0087 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2024-08-19 |
| Last Update Date | 2024-08-19 |