| NPI | 1255082632 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL GREENAWALT Partner/Owner/Oral Surgeon 360-698-9335 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-01-17 |
| Last Update Date | 2022-01-17 |