NPI | 1104249465 |
---|---|
Doing Business As | BREMERTON DENTAL |
Entity Type | Organization |
Authorized Contact | NATHAN GREGORY RUSSELL Doctor/Owner 360-377-7621 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE00009670) |
Enumeration Date | 2014-01-22 |
Last Update Date | 2014-01-22 |