| NPI | 1275757247 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT ROSS DRAKE President 253-474-9473 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WA 5247) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2007-07-25 |