| NPI | 1104147057 |
|---|---|
| Doing Business As | WESTSIDE CHILDREN'S DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | CHRISTINE M TWEEDY Owner 206-937-6481 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA 8359) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WA 8359) |
| Enumeration Date | 2010-06-15 |
| Last Update Date | 2010-06-15 |