| NPI | 1467874917 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SOFYA V KOCHUBEY Owner 253-238-1783 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122400000X Denturist (Licence: WA DN60141899) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA WA8905) |
| Enumeration Date | 2014-01-16 |
| Last Update Date | 2014-01-16 |