| NPI | 1346471687 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE A DODGE Consultant 206-931-4410 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: WA 600074615) |
| Enumeration Date | 2009-08-04 |
| Last Update Date | 2009-08-04 |