| NPI | 1073203485 | 
|---|---|
| Doing Business As | KO DENTAL | 
| Entity Type | Organization | 
| Authorized Contact | JEANA WARD Office Manager 206-624-7706  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics | 
| Enumeration Date | 2023-05-09 | 
| Last Update Date | 2023-05-09 |