| NPI | 1548827561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD HAWORTH Managing Member 360-452-4749 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2019-05-24 |
| Last Update Date | 2023-02-07 |