| NPI | 1184963845 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HANSROLF H GRUENER Owner 360-855-0351 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WA 603264506) |
| Enumeration Date | 2013-01-31 |
| Last Update Date | 2013-01-31 |