| NPI | 1407461270 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY CRISAFULLI Owner/Dentist 425-483-5838 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| 122300000X Dentist | |
| 1223P0300X Dentist, Periodontics | |
| 1223P0700X Dentist, Prosthodontics | |
| Enumeration Date | 2020-09-09 |
| Last Update Date | 2020-09-28 |