| NPI | 1548854409 |
|---|---|
| Doing Business As | DENTISTRY@ BONNEY LAKE |
| Entity Type | Organization |
| Authorized Contact | JESSICA GRISHAM Insurance Manager 253-845-6784 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2021-02-22 |
| Last Update Date | 2021-02-22 |