| NPI | 1184249278 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | QUINCY THOMPSON Owner 253-861-1173 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2020-06-15 |
| Last Update Date | 2021-02-11 |