| NPI | 1437605979 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA BLIDCHENKO Receptionist 253-854-6300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA 4845) |
| Enumeration Date | 2016-08-25 |
| Last Update Date | 2016-08-25 |