| NPI | 1235343526 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DYANNE K. MIDDAUGH Practice Manager 206-624-0852 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: WA 9246) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2020-08-22 |