| NPI | 1366520207 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTA M SMITH Office Manager 253-383-1471 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2014-12-29 |