| NPI | 1053326538 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDLE T CARR President 360-734-9926 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE00008137) |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2010-05-14 |