| NPI | 1487978250 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI WILLIAMS Office Manager 360-357-4500 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WA 10599) |
| Enumeration Date | 2010-03-22 |
| Last Update Date | 2013-10-29 |