| NPI | 1306393970 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLY ZEUTENHORST Syst EMS Administrator 509-966-2200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: WA 6312) |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2016-09-01 |