| NPI | 1457008435 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW SHANE EPSTEIN Owner/Provider 206-641-7212 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery |
| Enumeration Date | 2022-03-09 |
| Last Update Date | 2022-03-09 |