| NPI | 1396815221 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT TODD ERICKSON Officer 253-564-1000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: WA DE6354) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2020-08-22 |