| NPI | 1487774196 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE WILLIAMS Healthcare Business Office Director 360-312-2285 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2024-05-07 |