NPI | 1114045366 |
---|---|
Entity Type | Organization |
Authorized Contact | DEREK RICHARD DAMON President 360-676-6060 |
Organization Subpart ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WA DE 7966) |
Enumeration Date | 2007-03-27 |
Last Update Date | 2012-08-06 |