| NPI | 1144928276 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDY REIS Office Manager 206-375-8926 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2023-02-17 |
| Last Update Date | 2023-03-12 |