| NPI | 1275989527 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMARA L ODEN Office Manager 206-623-1140 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WA DE00008801) |
| Enumeration Date | 2016-05-05 |
| Last Update Date | 2016-05-05 |