| NPI | 1518006949 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE JOHNSON Owner 360-855-1689 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE00006322) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2008-06-12 |