| NPI | 1063865384 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARSON CALDERWOOD Owner 425-831-1790 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: WA 10227) |
| Enumeration Date | 2016-07-21 |
| Last Update Date | 2021-12-17 |