| NPI | 1417101197 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS LANE HOOFNAGLE Owner 360-676-1651 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WA DE00003572) |
| Enumeration Date | 2008-11-08 |
| Last Update Date | 2008-11-08 |