| NPI | 1356428601 |
|---|---|
| Other Name | ID DENTAL |
| Entity Type | Organization |
| Authorized Contact | HERMES SHAHBAZIAN CFO 206-788-3618 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA 600436519) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2021-03-29 |