| NPI | 1194991646 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TATE TODOROVIC Office Manager 425-487-1551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE00010721) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WA DE00010705) |
| 1223P0700X Dentist, Prosthodontics (Licence: WA DE00009891) | |
| 122400000X Denturist (Licence: WA DN00000331) | |
| Enumeration Date | 2008-05-05 |
| Last Update Date | 2008-05-05 |