| NPI | 1376808402 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SILAS D DUDLEY Owner 206-992-5098 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: WA DE60231571) |
| Enumeration Date | 2012-07-04 |
| Last Update Date | 2012-07-04 |