| NPI | 1174911044 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW ELDON LESH Owner 360-200-4924 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE60318472) |
| Enumeration Date | 2014-12-30 |
| Last Update Date | 2014-12-30 |