| NPI | 1184952079 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EPHRAIM ROLLOLAZO Office Manager 425-656-9025 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WA DE00007365) |
| Enumeration Date | 2009-12-03 |
| Last Update Date | 2009-12-03 |