| NPI | 1295276913 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY MARK PAVENTY Owner 509-475-5367 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D9209) |
| Enumeration Date | 2017-03-14 |
| Last Update Date | 2017-03-14 |