NPI | 1407476484 |
---|---|
Doing Business As | EASTSIDE MODERN DENTISTRY |
Entity Type | Organization |
Authorized Contact | SOFIA SEGURA Credentialing Manager 509-901-2239 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist |
Enumeration Date | 2020-04-20 |
Last Update Date | 2020-04-20 |