| NPI | 1083745137 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AARON P KELLY President 509-663-0536 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA 7070) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2020-08-22 |