| NPI | 1376932749 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE CLARK COMBS Owner 509-624-1139 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2015-01-22 |
| Last Update Date | 2015-01-22 |