| NPI | 1063929578 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARRETT GENTLING Owner 206-353-5567 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: WA DE60687419) |
| Enumeration Date | 2018-01-05 |
| Last Update Date | 2018-01-05 |