| NPI | 1457564536 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT B. ROURKE President 253-852-7331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WA DE00004668) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2020-08-22 |