| NPI | 1265441497 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTONIO CASO Owner 509-529-3760 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: WA DE00008739) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2020-08-22 |