| NPI | 1205176864 |
|---|---|
| Doing Business As | COWLITZ PERIODONTAL CARE & IMPLANT SURGARY |
| Entity Type | Organization |
| Authorized Contact | DONALD G ECHOLS Owner 360-423-8000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WA 6463) |
| Additional Taxonomies | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: WA 6463) |
| Enumeration Date | 2013-02-19 |
| Last Update Date | 2013-02-19 |