| NPI | 1184710022 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANE S DIEVENEY-HINKLE Co Owner 360-734-8846 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA 5701) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2020-08-22 |