| NPI | 1124365796 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY K HEGGERNESS President 206-242-4121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: WA DE00003686) |
| Enumeration Date | 2013-01-15 |
| Last Update Date | 2013-01-15 |