| NPI | 1083831085 |
|---|---|
| Doing Business As | PACIFIC NORTHWEST PERIODONTICS |
| Entity Type | Organization |
| Authorized Contact | SHANNON LEAH SINCLAIR Insurance COO Rdinator 206-575-1086 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist Periodontics (Licence: WA DE8508) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2008-07-23 |