| NPI | 1225481682 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTOPHER ALLEN JOHNSON Owner 425-348-8484 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WA 1223G0001X) |
| Enumeration Date | 2016-07-20 |
| Last Update Date | 2016-07-20 |