| NPI | 1447407739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI MUNSON Office Manager 509-764-0307 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE00010850) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WA DE60028802) |
| Enumeration Date | 2008-08-19 |
| Last Update Date | 2008-08-19 |