| NPI | 1083304455 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAM-TU VO Dentist 360-547-3687 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2023-05-10 |
| Last Update Date | 2023-06-15 |