| NPI | 1295289858 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES J PSOMAS Member 509-924-4411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA DE00006062) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA DE00009024) |
| Enumeration Date | 2016-08-11 |
| Last Update Date | 2016-08-11 |