| NPI | 1073826996 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GORDON BRUCE DAVIS President 425-348-1382 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2010-07-20 |
| Last Update Date | 2016-05-05 |