| NPI | 1275836801 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARA M CROSBY Practice Administrator 206-258-2010 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: WA DE60172592) |
| Enumeration Date | 2010-12-21 |
| Last Update Date | 2026-03-18 |