| NPI | 1376097691 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE J. BOUREKIS Owner 509-922-2288 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE 00007059) |
| Enumeration Date | 2016-08-04 |
| Last Update Date | 2016-08-04 |