| NPI | 1215365580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN R GIMSE Practice Administrator 425-745-6322 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2013-10-24 |
| Last Update Date | 2013-10-24 |