| NPI | 1427171818 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD LYNN WINCHELL President 360-577-8880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WA DE00004996) |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2020-08-22 |