| NPI | 1336441617 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTONELA POLOTANU Dentist 425-277-7592 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WA DE 00010919) |
| Enumeration Date | 2010-11-19 |
| Last Update Date | 2010-11-19 |