| NPI | 1265495196 |
|---|---|
| Doing Business As | EVERGREEN PEDIATRIC DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | SUSAN S KIM President 425-814-3196 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: WA 9731) |
| Enumeration Date | 2006-04-11 |
| Last Update Date | 2018-07-17 |