| NPI | 1477808160 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLE D GILL Sole Member 206-355-4360 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA 60035223) |
| Enumeration Date | 2012-07-18 |
| Last Update Date | 2012-07-18 |