| NPI | 1417960782 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE MARIE BEYER Financial Coordinator 425-485-6540 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA 5471) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WA 8485) |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2020-08-22 |