| NPI | 1285087296 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN R. OTTOSEN President 509-664-6669 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: WA 00007277) |
| Enumeration Date | 2016-07-14 |
| Last Update Date | 2016-07-14 |