| NPI | 1053654525 |
|---|---|
| Doing Business As | OLYMPIA PEDIATRIC DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | ANDREA MARIE VANCLEAVE Member 360-352-3515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: WA DE60284724) |
| Enumeration Date | 2013-04-02 |
| Last Update Date | 2013-04-02 |