| NPI | 1467599480 |
|---|---|
| Other Name | DENTAL |
| Entity Type | Organization |
| Authorized Contact | RHONDA HAUFF Primary Care Administrator 509-454-4143 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2007-07-17 |