| NPI | 1316010531 |
|---|---|
| Doing Business As | PANTHER LAKE DENTAL |
| Entity Type | Organization |
| Authorized Contact | JAY D DEIGLMEIER President 253-854-1222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE00007064) |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2020-08-22 |