| NPI | 1497013551 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LANCE JORDAN HEPPLER Dentist 360-896-1449 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: WA 8437) |
| Enumeration Date | 2012-04-26 |
| Last Update Date | 2012-04-26 |