| NPI | 1518406339 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLEN BURLESON Owner Dental Lab 360-871-2444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 292200000X Dental Laboratory (Licence: WA 603128257) |
| Enumeration Date | 2017-02-13 |
| Last Update Date | 2017-02-13 |