| NPI | 1083916738 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK ALAN STAHL President, Secretary, Treasurer 206-522-0466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE60076890) |
| Enumeration Date | 2010-12-01 |
| Last Update Date | 2010-12-01 |