| NPI | 1053521393 |
|---|---|
| Doing Business As | THE OLD FIREHOUSE DENTAL OFFICE |
| Entity Type | Organization |
| Authorized Contact | WILLIAM MARC PETERSEN President 509-325-4227 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2008-06-17 |