| NPI | 1235204181 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JODI W FUNK Owner Presidnet 509-747-4242 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE00001693) |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2008-06-18 |