| NPI | 1184284689 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIANNA CREWSE Financial COO Rdinator 509-525-7030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2019-06-17 |
| Last Update Date | 2019-06-17 |