| NPI | 1194125062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIA M MCGARY Owner 360-659-3232 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA DE00009378) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment |
| Enumeration Date | 2014-08-28 |
| Last Update Date | 2016-09-14 |