| NPI | 1134564032 |
|---|---|
| Doing Business As | HAWKS PRAIRIE PEDIATRIC DENTISTRY/ WEST OLYMPIA KIDS DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | KENNETH A BLOCH Attorney 206-682-3840 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: WA DE60112868) |
| Enumeration Date | 2013-05-06 |
| Last Update Date | 2018-09-21 |