| NPI | 1285948646 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIEL D LOISEAU President 509-765-1748 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WA DE60099971) |
| Enumeration Date | 2010-07-28 |
| Last Update Date | 2012-05-19 |