| 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 |