| NPI | 1295040327 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JARED DOUGLAS PERSINGER Dentist/Owner 360-459-1600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE60170217) |
| Enumeration Date | 2010-08-12 |
| Last Update Date | 2012-01-31 |