| NPI | 1457541021 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA LEE STOLBERG Department Chair 509-368-6528 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA 4864) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WA 6554) |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2009-11-03 |