| NPI | 1386192052 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIANN JAEGER Office Manager 509-248-5181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WA DE60191920) |
| Enumeration Date | 2016-09-12 |
| Last Update Date | 2016-09-12 |