| NPI | 1508038860 |
|---|---|
| Doing Business As | SAINT MARY'S WIC DENTAL PROGRAM |
| Entity Type | Organization |
| Authorized Contact | JOHN DEAKYNE Chief Financial Officer 775-770-6239 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2008-03-27 |
| Last Update Date | 2012-03-27 |