| NPI | 1053678102 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY M CHRISTENSEN Office Manager 509-547-0730 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA 5582) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA 60232759) |
| Enumeration Date | 2012-04-13 |
| Last Update Date | 2012-04-13 |