| NPI | 1538480215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIE M HARDIE Pediatric Dentist/ Owner 360-241-4361 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: WA DE00008741) |
| Enumeration Date | 2010-06-17 |
| Last Update Date | 2010-06-17 |