NPI | 1477911410 |
---|---|
Entity Type | Organization |
Authorized Contact | ROGELIO RIOJAS Executive Director 206-788-3226 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
Additional Taxonomies | 122300000X Dentist |
1223G0001X Dentist General Practice | |
1223P0221X Dentist Pediatric Dentistry | |
1223X0400X Dentist Orthodontics and Dentofacial Orthopedics | |
Enumeration Date | 2016-02-05 |
Last Update Date | 2023-09-11 |