| NPI | 1336427897 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA R KNIGHT Account Receivables Manager 360-659-8100 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry |
| Enumeration Date | 2011-08-01 |
| Last Update Date | 2022-04-11 |