| NPI | 1215269188 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLE CHRISTINE MARTIN Dentist/Owner 206-228-7609 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA DE00010992) |
| Enumeration Date | 2010-02-03 |
| Last Update Date | 2010-02-03 |