| NPI | 1336320621 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTIN HUMPHREY Office Manager 509-624-2204 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2007-11-15 |
| Last Update Date | 2009-02-13 |