| NPI | 1306187836 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESTER B KENNINGTON President 360-247-9100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WA DE00009274) |
| Enumeration Date | 2013-03-07 |
| Last Update Date | 2013-03-07 |