| NPI | 1255218434 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER PETROZZI Administrator 360-218-7970 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2025-08-19 |
| Last Update Date | 2025-08-19 |