| NPI | 1295844900 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER SIGMAN Chief Operating Officer 360-254-5254 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2007-08-29 |