| NPI | 1134429848 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | M'LISSA RAJCICH Owner 253-845-7583 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2010-10-27 |
| Last Update Date | 2010-10-27 |