| NPI | 1407944614 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA JEAN CASWELL Office Manager 360-736-0715 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2020-08-22 |