| NPI | 1215156278 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS G WHITE President 360-676-1401 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: WA DE00003751) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2020-08-22 |