| NPI | 1073763041 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY L BIRCH President/Owner 360-457-3183 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: WA 602789281) |
| Enumeration Date | 2008-09-25 |
| Last Update Date | 2008-09-25 |