| NPI | 1083849913 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRAIG W WONG Owner/President 360-695-2400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: WA WA5774) |
| Enumeration Date | 2009-05-21 |
| Last Update Date | 2009-11-19 |