NPI | 1235790510 |
---|---|
Entity Type | Organization |
Authorized Contact | HILLARY ANNE BERRY Manager 425-409-1655 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist |
Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
Enumeration Date | 2019-06-26 |
Last Update Date | 2022-10-03 |