| NPI | 1366624629 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA ADRIENNE NICOARA Owner/Periodontist 425-374-5380 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: WA 10770) |
| Enumeration Date | 2007-11-28 |
| Last Update Date | 2007-11-28 |