| NPI | 1255531018 |
|---|---|
| Doing Business As | KIDSMILE DENTAL |
| Entity Type | Organization |
| Authorized Contact | T. JOEL BLAKE Owner/Dentist 509-926-1234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: WA 9846) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WA 10588) |
| Enumeration Date | 2007-07-20 |
| Last Update Date | 2009-03-31 |