| NPI | 1134677792 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA OCTAVIA REAMES Office Manager 425-354-5704 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: WA DE60455178) |
| Enumeration Date | 2016-09-13 |
| Last Update Date | 2016-09-13 |