| NPI | 1467900241 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NAVID NEWPORT Owner 360-747-2111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2016-09-21 |
| Last Update Date | 2024-12-03 |