| NPI | 1447339486 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY VELLING Member 206-767-3480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE00007670) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2008-09-16 |