| NPI | 1104019660 |
|---|---|
| Doing Business As | BELLA VISTA DENTURE CLINIC, PLLC |
| Entity Type | Organization |
| Authorized Contact | JOSHUA D BROOKS Sole Member 509-786-2963 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122400000X Denturist |
| Enumeration Date | 2007-08-19 |
| Last Update Date | 2007-08-19 |