| NPI | 1477843266 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY JOHN MATSON Dentist 253-833-6120 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: WA 6377) |
| Enumeration Date | 2011-04-13 |
| Last Update Date | 2011-11-16 |