| NPI | 1285798728 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHEL GORMAN Office Manager 360-735-0222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: WA DE00007037) |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2008-04-08 |