| NPI | 1225245574 |
|---|---|
| Doing Business As | GENTLE DENTAL FLAMINGO |
| Entity Type | Organization |
| Authorized Contact | BRADLEY R PETERSON Pc Owner/President 360-869-7645 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2025-02-07 |