NPI | 1437494036 |
---|---|
Entity Type | Organization |
Authorized Contact | VENN ROGER PETERSON President 360-459-4420 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE00008985) |
Enumeration Date | 2012-12-07 |
Last Update Date | 2012-12-07 |