| NPI | 1538615158 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | J. R. CRAIG WEBSTER D D S Owner 509-826-1260 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: WA 4412) |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2016-09-01 |