| NPI | 1215326202 |
|---|---|
| Doing Business As | SOUTHRIDGE DENTAL |
| Entity Type | Organization |
| Authorized Contact | ERIC WINTERTON Dentist 509-581-0081 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WA DE60232632) |
| Enumeration Date | 2015-01-14 |
| Last Update Date | 2015-01-14 |