| NPI | 1487159331 |
|---|---|
| Doing Business As | SOUTHRIDGE DENTAL |
| Entity Type | Organization |
| Authorized Contact | SEAN F.M. SIMPER Owner, Dentist 509-581-0081 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA DE60023578) |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2018-03-23 |