| NPI | 1093078412 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES MICHAEL JONES Vice President 360-943-4644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA DE00007112) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA DE00006203) |
| 122300000X Dentist (Licence: WA DE60016751) | |
| Enumeration Date | 2012-06-20 |
| Last Update Date | 2012-06-20 |