NPI | 1235509639 |
---|---|
Doing Business As | MAPLE STREET FAMILY DENTISTRY |
Entity Type | Organization |
Authorized Contact | MICHELLE RENEE OLMSTEAD Owner/Dentist 509-891-5001 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE00008465) |
Enumeration Date | 2015-09-29 |
Last Update Date | 2015-09-29 |