| NPI | 1245205319 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS ELDRED DANCE President 360-698-5911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA 4571) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WA 4564) |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2020-08-22 |