| NPI | 1275858029 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW YEH Dentist 360-389-3198 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: WA DE00009470) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA DE00009470) |
| Enumeration Date | 2010-04-05 |
| Last Update Date | 2020-06-11 |