NPI | 1184830788 |
---|---|
Doing Business As | GENTLE DENTAL GREEN VALLEY |
Entity Type | Organization |
Authorized Contact | BRADLEY R PETERSON Pc Owner/President 360-869-7645 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist |
Enumeration Date | 2007-05-14 |
Last Update Date | 2025-02-07 |