| NPI | 1073936837 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID A CLARK Owner 509-966-2230 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE60023580) |
| Enumeration Date | 2014-01-30 |
| Last Update Date | 2014-01-30 |