| NPI | 1104624170 |
|---|---|
| Doing Business As | WENATCHEE WISDOM TEETH |
| Entity Type | Organization |
| Authorized Contact | RICARDO ALFONSO COLUNGA Business Director 509-885-5703 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2025-03-05 |
| Last Update Date | 2025-03-21 |