| NPI | 1548716343 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AJ GOLLOFON President 206-363-7200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WA DE00006208) |
| Enumeration Date | 2016-08-31 |
| Last Update Date | 2016-08-31 |