| NPI | 1528139698 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER KATHERINE KING Owner 509-697-4821 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE000008213) |
| Enumeration Date | 2006-11-12 |
| Last Update Date | 2020-08-22 |