| NPI | 1295947448 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERENCE C SULLIVAN Owner 425-385-2641 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WA DE00006911) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2020-08-22 |