| NPI | 1528411600 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA G WITTER Office Manager 509-838-4141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| 124Q00000X Dental Hygienist | |
| 126800000X Dental Assistant | |
| 126900000X Dental Laboratory Technician | |
| Enumeration Date | 2016-07-13 |
| Last Update Date | 2016-07-13 |